L'avortement en Afrique (Bibliographie)
2003
2002Article de périodique
Fullerton J.; Fort A.; Johal K.
A case/comparison study in the Eastern Region of Ghana on the effects of incorporating selected reproductive health services on family planning services
2003 - Midwifery, 19(1), p. 17-26
Mots clés : avortement; adolescence; adolescent; planning familial; service de santé
Pays / Régions : GhanaRésumé : OBJECTIVE: to assess the impact on the provision of family planning (FP) services when FP providers were also trained to provide additional, selected, reproductive health services
Source : Source : Midwifery.Chapitre d'ouvrage
Singh S.; Stanley K. H.; Berentsen K.
Abortion: A Worldwide Overview
2003 - In A.M. Basu (Ed.) The sociocultural and political aspects of abortion - Global perspectives, p. 15-48. Westport, Connecticut London: Westport, Connecticut London
Mots clés : méthodologie
Source : source : ceped.Article de périodique
Airede L.R.; Ekele B.A.
Adolescent maternal mortality in Sokoto, Nigeria
2003 - J Obstet Gynaecol, 23(2), p. 163-165
Mots clés : adolescence; adolescent
Pays / Régions : NigeriaRésumé : The aim of this study was to determine the magnitude of adolescent maternal deaths at the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Risk factors included absence of routine antepartum, intrapartum and postpartum care, illiteracy and poverty. Eclampsia and prolonged obstructed labour were responsible for 76% of deaths. Abortion was an uncommon cause of maternal death in adolescents. There is an unacceptably high level of maternal mortality in adolescents at UDUTH, Sokoto. Tragically, most deaths are preventable.
Source : source : J Obstet Gynaecol.Article de périodique
Hollander D.
Although abortion is highly restricted in Cameroon, it is not uncommon among young urban women
2003 - International Family Planning Perspectives, 29(1), p. 49-50
Mots clés : avortement; loi; méthode; adulte; âge; âge; épidémiologie; décision; femme; homme; relation; connaissance; fécondité; grossesse; sexualité; facteur socio-économique
Pays / Régions : Cameroun
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2904903.html.Chapitre d'ouvrage
Renne E.P.
Changing Assessments of Abortion in a Northern Nigerian Town
2003 - In A.M. Basu (Ed.) The sociocultural and political aspects of abortion - Global perspectives, p. 119-138. Westport, Connecticut London: Westport, Connecticut London
Pays / Régions : Nigeria
Source : source : ceped.Chapitre d'ouvrage
Levin E.
Cleaning the Belly: Managing Menstrual Health in Guinea, West Africa
2003 - In A.M. Basu (Ed.) The sociocultural and political aspects of abortion - Global perspectives, p. 103-118. Westport, Connecticut London: Westport, Connecticut London
Pays / Régions : Guinée
Source : source : ceped.Article de périodique
Tabbutt Henry J.; Graff K.
Client-Provider Communication in Postabortion Care
2003 - International Family Planning Perspectives, 29(3), p. 126-129
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2912603.html.Chapitre d'ouvrage
Basu A.M.
Concluding Remarks: The Role of Ambiguity
2003 - In A.M. Basu (Ed.) The sociocultural and political aspects of abortion - Global perspectives, p. 249-260. Westport, Connecticut London: Westport, Connecticut London
Mots clés : facteur politique
Source : source : ceped.Chapitre d'ouvrage
Kulczycki A.
Demographic Research and Abortion Policy: limits to the Use of Statistics
2003 - In A.M. Basu (Ed.) The sociocultural and political aspects of abortion - Global perspectives, p. 65-78. Westport, Connecticut London: Westport, Connecticut London
Mots clés : politique; programme
Source : source : ceped.Article de périodique
Corbett M.R.; Katherine L. T.
Essential Elements of Postabortion Care: Origins, Evolution and Future Directions
2003 - International Family Planning Perspectives, 29(3), p. 106-111Résumé : no abstract
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2910603.html.Article de périodique
Rossier C.
Estimating induced abortion rates: a review
2003 - Studies in Family Planning., 34(2.), p. 87-102
Pays / Régions : AfriqueRésumé : Legal abortions are authorized medical procedures, and as such, they are or can be recorded at the health facility where they are performed. The incidence of illegal, often unsafe, induced abortion has to be estimated, however. In the literature, no fewer than eight methods have been used to estimate the frequency of induced abortion: the "illegal abortion provider survey," the "complications statistics" approach, the "mortality statistics" approach, self-reporting techniques, prospective studies, the "residual" method, anonymous third party reports, and experts' estimates. This article describes the methodological requirements of each of these methods and discusses their biases. Empirical records for each method are reviewed, with particular attention paid to the contexts in which the method has been employed successfully. Finally, the choice of an appropriate method of estimation is discussed, depending on the context in which it is to be applied and on the goal of the estimation effort. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 182031.Article de périodique
Zebaze R.M.
HIV infections in sub-Saharan Africa
2003 - Int J STD AIDS, 14(6), p. 428-429
Mots clés : VIH; sida; risque; maladie; maladie; complication; comportement
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : The study by Gisselquist et al. is of the utmost importance, as it helps health professionals and policy makers to face the bitter reality of a broken health system. In my opinion as a medical graduate with experience in practice in Cameroon, Central Africa in both rural and urban areas, it seems extremely unlikely that sexual behaviour or vertical transmission could explain the large number of new cases diagnosed daily. I do not, however, agree with the authors' analysis of other possible causes; I believe that too much importance is placed on unsafe injections by health professionals. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 179364.Chapitre d'ouvrage
Caldwell J.C.; Caldwell P.
Introduction: Induced Abortion in a Changing World
2003 - In A.M. Basu (Ed.) The sociocultural and political aspects of abortion - Global perspectives, p. 1-14. Westport, Connecticut London: Westport, Connecticut London
Source : source : ceped.Article de périodique
Mohammed I.
Issues relating to abortions are complicated in Nigeria letter
2003 - BMJ. British Medical Journal, 326(7382), p. 225
Mots clés : mortalité maternelle; médicament; loi; culture; religion; mortalité; population; facteur démographique; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : None of the responses to the news item on bmj.com considered the complex social and religious milieu in which Nigerians live. It is not the absence or paucity of medical expertise, health education, or activity by non-governmental organisations that drives pregnant girls to underground abortion clinics. Very strong cultural and religious stigmas are associated with extramarital sex in all regions of the country: not only Islam but also the Roman Catholic Church strongly oppose liberalisation of abortion. To legislate on abortion is a very tall order in Nigeria. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 175061.Article de périodique
Aziken M.E.; Okonta P.I.; Adedapo B.A. A.
Knowledge and Perception of Emergency Contraception Among Female Nigerian Undergraduates
2003 - International Family Planning Perspectives, 29(2), p. 84-87
Mots clés : contraception d'urgence; contraception postcoitale; étudiant; scolarisation
Pays / Régions : NigeriaRésumé : CONTEXT: The reproductive health hazards of unintended pregnancies and unsafe abortions are well documented. The potential of emergency contraceptives to prevent unwanted pregnancy in developed countries has been described, but in Nigeria, the awareness about the method is poor and no study has looked at efficacy. METHODS: Between September and October 2001, a randomly selected sample of female undergraduate students at the University of Benin, Nigeria, were surveyed about their demographic information, sexual history and contraceptive use, and their awareness and knowledge of emergency contraception. RESULTS: Of the 880 respondents, 43% were sexually active, 39% had ever practiced contraception and 34% had ever had an induced abortion. Overall, 58% of respondents reported knowing about emergency contraception; sexually active respondents were significantly more likely than those who were not and those who had ever practiced contraception were more likely than those who had not to be aware of emergency contraceptives. However, only 18% of respondents who reported knowing about emergency contraception knew the correct time frame in which emergency contraceptives must be used to be effective. CONCLUSION: There is an urgent need to educate Nigerian young people about emergency contraception, emphasizing available methods and correct timing of use.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2908403.html.Chapitre d'ouvrage
Stambach A.
Kutoa Mimba: Debates about Schoolgirl Abortion in Machame, Tanzania
2003 - In A.M. Basu (Ed.) The sociocultural and political aspects of abortion - Global perspectives, p. 79-102. Westport, Connecticut London: Westport, Connecticut London
Pays / Régions : Tanzanie
Source : source : ceped.Article de périodique
Guillaume A.
Le rôle de l'avortement dans la transition de la fécondité à Abidjan au cours des années 1990
2003 - Population, 58(6), p.
Mots clés : méthodologie; ville; résidence; déterminant fécondité; avortement; incidence; population; facteur démographique; fécondité; contraception d'urgence; contraception postcoitale; planning familial; mesure
Pays / Régions : Cote d'Ivoire; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : A l'image de nombreux pays africains, la Côte d'Ivoire est entrée dans une phase de transition de sa fécondité, particulièrement marquée en milieu urbain. Ces changements se produisent dans un contexte de faible prévalence contraceptive ; la question du rôle des autres déterminants dans ces évolutions se pose en particulier celle de l'avortement. Une étude menée dans la ville d'Abidjan auprès de femmes en consultation dans des centres de santé a permis d'analyser en détail les modes de régulation de la fécondité et les relations entre avortement et fécondité. L'avortement est une pratique de plus en plus fréquente, malgré son illégalité, notamment chez les jeunes femmes et dès le début de la vie féconde. Contraception et avortement sont parfois utilisés de façon complémentaire, l'avortement intervenant suite à l'échec d'une contraception (en particulier d'une méthode naturelle). Dans certains cas, après l'expérience d'un avortement le recours à des méthodes efficaces semble augmenter, bien que cela ne soit pas systématique. Les données présentées ici montrent qu'il n'est pas possible de comprendre la baisse de la fécondité à Abidjan, sans prendre en compte le rôle majeur des pratiques abortives.
Source : source : Population : http://www.ined.fr/publications/population/index.html.Article de périodique
Nash E.S.
Legal termination of pregnancy
2003 - S Afr Med J, 93(2), p. 87
Pays / Régions : Afrique du Sud
Source : source : S Afr Med J.Article de périodique
Orji E.O.; Adeyemi A.B.; Esimai O.A.
Liberalisation of abortion laws in Nigeria: the undergraduates' perspective
2003 - J Obstet Gynaecol, 23(1), p. 63-66
Mots clés : avortement
Pays / Régions : NigeriaRésumé : A study about 396 undergraduates of Obafemi Awolowo University, Ile-Ife, Nigeria concerning their opinopn on the liberalisation of abortion laws were investigated in May 2001. 22.7% of respondents supported the liberalisation of abortion laws in Nigeria because they believed that it would lead to reduction in associated morbidity and mortality, encourage more qualified personnel to perform it, encourage women to request abortion openly and encourage accurate statistics on abortion. However, the majority of the respondents opposed the liberalisation of abortion laws due to the fear that it would increase promiscuity, sexually transmitted diseases and abortion rates. Religious opposition and the belief that liberalisation would not reduce the level of poverty, ignorance and poor reproductive health facilities were the common factors leading to unwanted pregnancy and unsafe abortion in Nigeria.
Source : source : J Obstet Gynaecol.Article de périodique
Brown H.; Jewkes R.; Levin J.; Dickson Tetteh K.; Rees H.
Management of incomplete abortion in South African public hospitals
2003 - International Journal of Obstetrics and Gynaecology., 110(4), p. 371-377
Mots clés : méthodologie; enquête; complication; soin post-abortum; antibiotiques; méthode; étudiant; scolarisation; avortement; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé; médicament; méthode; traitement; soin
Pays / Régions : Afrique du Sud; Afrique Anglophone; Afrique; Afrique Australe; Afrique SubsaharienneRésumé : Objective: To describe the current management of incomplete abortion in South African public hospitals and to discuss the extent to which management is clinically appropriate. Design: A multicentre, prospective descriptive study. Setting South African public hospitals that manage gynaecological emergencies. Sample: Hospitals were selected using a stratified random sampling method. All women who presented to the above sampled hospitals with incomplete abortion during the three week data collection period in 2000 were included. Methods: A data collection sheet was completed at the time of discharge for each woman admitted with a diagnosis of incomplete, complete, missed or inevitable abortion during the study period. Information gathered included demographic data, clinical signs and symptoms at admission, medical management, surgical management, anaesthetic management, use of blood products and antibiotics and complications. Three clinical severity categories were used for the purpose of data analysis and interpretation. Main outcome measures: Detail of medical management, detail of surgical management, use of blood products and antibiotics, methods of analgesia and anaesthesia used, and use of abortifacients. Results: There is a trend towards low cost technology such as the use of manual vacuum aspiration and sedation anaesthesia; however, this is mainly limited to the better resourced tertiary hospitals linked to academic units. The use of antibiotics and blood products has decreased but much of the use is inappropriate. The use of abortifacients does include some use of misoprostol but merely as an adjunct to surgical evacuation. Conclusions: The management of incomplete abortion remains a problem in South Africa, a low income country that is still managing a common clinical problem with costly interventions. The evidence of a trend towards low cost technology is promising, albeit limited to tertiary centres. This study has given us information as how to best address this problem. More training in low cost methods is needed, targeting in particular the district and regional hospitals, and reinforced by skills training focussed mainly on undergraduates and midwife post-abortion care programmes. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 178336.Article de périodique
Ikechebelu J.I.; Okoli C.C.
Morbidity and mortality following induced abortion in Nnewi, Nigeria
2003 - Trop Doct, 33(3), p. 170-172
Mots clés : mortalité maternelle
Pays / Régions : Nigeria
Source : source: trop doctor.Article de périodique
Dale H.; Nawar L.
Moving from Research to Program--The Egyptian Postabortion Care Initiative
2003 - International Family Planning Perspectives, 29(3), p. 121-125Résumé : no abstract
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2912103.html.Article de périodique
Marston C.; Cleland J.
Relationships between contraception and abortion: a review of the evidence
2003 - International Family Planning Perspectives, 29(1), p. 6-13
Mots clés : avortement; loi; données; tendance; taux natalité; contraception; méthode contraceptive; épidémiologie; femme; homme; incidence; grossesse; prévalence
Pays / Régions : Cuba; Europe; Kazakhstan; Corée; Singapour; Tunisie; Etats UnisRésumé : CONTEXT: The relationship between levels of contraceptive use and the incidence of induced abortion continues to provoke heated discussion, with some observers arguing that use of abortion decreases as contraceptive prevalence rises and others claiming that increased use of family planning methods causes abortion incidence to rise. METHODS: Abortion trends are examined in countries with reliable data on abortion and with contraceptive prevalence information from two points in time showing increases in contraceptive use. The role of changes in fertility in mediating the relationship between abortion and contraception is also explored. RESULTS: In seven countries--Kazakhstan, Kyrgyz Republic, Uzbekistan, Bulgaria, Turkey, Tunisia and Switzerland--abortion incidence declined as prevalence of modern contraceptive use rose. In six others--Cuba, Denmark, Netherlands, the United States, Singapore and the Republic of Korea--levels of abortion and contraceptive use rose simultaneously. In all six of these countries, however, overall levels of fertility were falling during the period studied. After fertility levels stabilized in several of the countries that had shown simultaneous rises in contraception and abortion, contraceptive use continued to increase and abortion rates fell. The most clear-cut example of this trend is the Republic of Korea. CONCLUSIONS: Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant. The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2900603.html.Article de périodique
Roberts H.
Reproductive health struggles in Nigeria
2003 - Lancet, 361(9373), p. 1966
Mots clés : santé de la reproduction; service de santé; santé; soin
Pays / Régions : Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : On May 29, President Olusegun Abasanjo was inaugurated in Nigeria. The previous week, National Safe Motherhood Day received little attention, despite the 60 000 deaths each year among Nigerian women due to complications of pregnancy and childbirth, an infant mortality rate of 75 per 1000 live births, and an HIV rate of at least 5·8%. Nigeria-often regarded as the powerhouse of Africa-risks becoming unable to support its 120 million people. Furthermore, the population is predicted to double within the next 24 years. As the government acknowledges, "Nigeria would have to double its entire infrastructure for food production, health services, education, water supply, housing, energy, and services just to maintain today's low standard of living." Following decades of mismanagement and rule by military dictatorships, 66% of the population live below the poverty line on less than US$1 a day, only 40% of households have access to potable water, and corruption is endemic. (Transparency International ranks Nigeria as the most corrupt country in Africa.)(excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 180056.Article de périodique
El Tagy A.; Sakr E.; Sokal D.C.; Issa A.H.
Safety and acceptability of post-abortal IUD insertion and the importance of counseling
2003 - Contraception, 67(3), p. 229-234
Mots clés : avortement; adolescence; adolescent; adulte; âge; contraception; méthode contraceptive; effets secondaires; méthode; counseling; planning familial; femme; homme; DIU; Stérilet; contraception; grossesse
Pays / Régions : EgypteRésumé : This nonrandomized observational clinical study evaluated the safety and acceptability of intrauterine device insertion either immediately or 2 weeks after abortion, according to the patient's preference. Participants were 300 women with first-trimester abortions who agreed to immediate or delayed insertion. End points were bleeding patterns, pregnancy, expulsion, perforation, infection and device removal at 2, 6 and 10 weeks after insertion, and acceptance rates before and after counseling procedures were improved. The overall initial acceptance rate was 35.8%, and the actual acceptance rate was 31.7%. After counseling procedures were improved, the initial and actual acceptance rates increased substantially (17.7% vs. 44.3% and 10.2% vs. 42.0%, respectively). Bleeding, expulsion rates and pain did not differ significantly between the immediate and delayed insertion groups after IUD insertion. No pregnancies, perforations or cases of pelvic inflammatory disease were recorded in either group. Immediate post-abortal insertion offers the advantage of being a painless procedure. The quality of counseling is critical to improving acceptance of post-abortion contraception.
Source : Abstract from CONTRACEPTION, V67(3): 229-234, El-Tagy A et al: "Safety and acceptability of post-abortal IUD insertion and the importance of counseling © 2003 Elsevier Inc.Article de périodique
Glover E.K.; Bannerman A.; Pence B.W.; Jones H.; Miller R.; Weiss E.; Nerquaye Tetteh J.
Sexual health experiences of adolescents in three Ghanaian towns
2003 - International Family Planning Perspectives, 29(1), p. 32-40
Mots clés : adolescence; adolescent; adulte; âge; âge; contraception; méthode contraceptive; femme; genre; épidémiologie; homme; relation; connaissance; grossesse; viol; sexualité; violence; psychologie; facteur psychologique
Pays / Régions : GhanaRésumé : CONTEXT: Ghanaian youth are greatly affected by widespread social change, and their reproductive health needs may differ by social group, age and gender. METHODS: In-person interviews on sexual health issues were conducted with 704 never-married youth aged 12-24 in three Ghanaian towns. The sample included youth who were in school, in apprenticeship programs or in neither school nor apprenticeship programs (unaffiliated). RESULTS: More than half of the respondents had ever had sexual intercourse (52%), with the adjusted odds for females being 1.6 times those for males and the odds for unaffiliated and apprenticed youth being 2.5-3.2 times those for in-school youth. The odds of having had sex in the previous month were elevated for females (2.0) and apprentices (2.7). Both sexes tended to accept violence towards women, with unaffiliated youth showing the highest level of acceptance and in-school youth the lowest. Nearly all respondents (99%) knew of condoms, but fewer than half (48%) could identify any of four elements of correct use; females and sexually inexperienced youth were the least informed. Two-thirds of respondents considered it unacceptable for males to carry condoms, and three-quarters considered it unacceptable for females. Twenty-five percent of males and 8% of females reported having had a sexually transmitted infection. One-third of sexually experienced females reported having ever been pregnant; of those, 70% reported having had or having attempted to have an abortion. CONCLUSIONS: Adolescent reproductive health programs should be targeted to the needs of specific groups.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2904903.html.Chapitre d'ouvrage
Mundigo A.I.
The Challenge of Induced Abortion Research: Transdisciplinary Perspectives
2003 - In A.M. Basu (Ed.) The sociocultural and political aspects of abortion - Global perspectives, p. 49-64. Westport, Connecticut London: Westport, Connecticut London
Source : source : ceped.Article de périodique
Sibanda A.; Woubalem Z.; Hogan D.P.; Lindstrom D.P.
The proximate determinants of the decline to below-replacement fertility in Addis Ababa, Ethiopia
2003 - Studies in Family Planning, 34(1), p. 1-7
Mots clés : méthodologie; enquête; déterminant fécondité; fécondité; contraception; méthode contraceptive; étudiant; scolarisation; population; facteur démographique; taux fécondité; taux natalité
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : Between 1990 and 2000, the total fertility rate (TFR) in Ethiopia declined moderately from 6.4 to 5.9 children per woman of reproductive age. During the same period, the TFR in the capital city of Addis Ababa declined from 3.1 to 1.9 children per woman. Even more striking than the magnitude of this decline is that it occurred in the absence of a strong and effective national family planning program. In this study, the components of this fertility decline are identified using the Bongaarts framework of the proximate determinants of fertility. The results of a decomposition analysis indicate that a decrease in the age-specific proportions of women who are married, followed by an increase in contraceptive use are the most important mechanisms by which fertility has declined in Addis Ababa. Poor employment prospects and relatively high housing costs are likely factors that encourage couples to delay marriage and reduce marital fertility. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 177243.Chapitre d'ouvrage
Anarfi J.K.
The Role of Local Herbs in the Recent Fertility Decline in Ghana: Contraceptives or Abortifacients?
2003 - In A.M. Basu (Ed.) The sociocultural and political aspects of abortion - Global perspectives, p. 139-152. Westport, Connecticut London: Westport, Connecticut London
Source : source : ceped.Ouvrage
Basu A.M.
The sociocultural and political aspects of abortion - Global perspectives.
2003 - Westport, Connecticut London: Praeger, 275 p.Résumé : Seeking to define the ways various cultures view pregnancy, miscarriage, and abortion, this multidisciplinary collection of essays seeks to illustrate how these views influence policy decisions and practices regarding abortion around the world. Putting questions of pro-life and pro-choice aside, the contributors provide demographic coverage of the issues involved and contextualize some of the personal realities that underlie the approximately 50 million abortions that are believed to take place yearly worldwide. While the political and social climates in which women seek abortions vary from place to place, many of the chapters try to understand the moral implications that guide the decision to end a pregnancy from the perspective of the those who seek to do so. Focusing primarily on developing nations, this important contribution to the literature on abortion provides readers with a careful overview of the different meanings attached to abortion depending on the cultural, social, and political climate. Areas covered include Tanzania, Bangladesh, West Africa, Ghana, Romania, Russia, Mexico, and Nigeria. General chapters on induced abortion, demographic research and abortion policy, and social pressures to abort are also included. This unique approach to the study of abortion will contribute to a greater understanding of a prominent social issue
Source : source : ceped.Article de périodique
Geelhoed D.; Visser L.; Asare K.; Schagen van Leeuwen J.H.; van Roosmalen J.M.
Trends in maternal mortality: a 13-year hospital-based study in rural Ghana
2003 - European Journal of Obstetrics, Gynecology and Reproductive Biology, 107(2), p. 135-139
Mots clés : méthodologie; enquête; rural; résidence; mortalité maternelle; décès; santé; complication grossesse; étudiant; scolarisation; facteur géographique; population; mortalité; facteur démographique; communication; maladie; complication
Pays / Régions : Ghana; Afrique Anglophone; Afrique; Afrique de l'Ouest; Afrique SubsaharienneRésumé : Objective: To measure the impact of the Safe Motherhood Initiative (SMI) on hospital-based maternal mortality since its start in 1987. Study design: Retrospective analysis of all 229 maternal deaths in a district hospital in rural Ghana, between 1 January 1987 and 1 January 2000. Main outcome measures were maternal mortality ratio and relative contribution of causes of maternal deaths to overall maternal mortality. Chi-square test was used to assess differences in proportions, and relative risks with confidence intervals were calculated. Results: The overall maternal mortality ratio of 1077/100,000 live births did not change significantly during the study period. However, the relative contributions of sepsis, hemorrhage, obstructed labor, anemia/sickle cell disease and (pre-) eclampsia diminished, while abortion complications increased significantly. Conclusions: The Safe Motherhood Initiative in the study area has contributed to the reduction of maternal mortality due to causes against which interventions were directed. Abortion complications as cause of maternal mortality need to be included in interventions and research. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 177582.
2001Article de périodique
Moosa N.
A descriptive analysis of South African and Islamic abortion legislation and local Muslim community responses
2002 - Med Law, 21(2), p. 257-279
Mots clés : religion
Pays / Régions : Afrique du SudRésumé : The issue of abortion has been the subject of much debate in the recent past in South Africa. Prior to 1996 abortion legislation was punitive and therefore one with which conservative Muslims could identify. Since 1996 the law has been liberalized and replaced by a new Act.
Source : source : med law.Article de périodique
Fasubaa O.B.; Akindele S.T.; Adelekan A.; Okwuokenye H.
A politico-medical perspective of induced abortion in a semi-urban community of Ile-Ife, Nigeria
2002 - J Obstet Gynaecol, 22(1), p. 51-57
Mots clés : connaissance
Pays / Régions : NigeriaRésumé : This study is designed to document a semi-urban community perspective on induced abortion in Ile-Ife, Nigeria, with a view to estimating community awareness, attitudes and implications of its existence in the community and providing relevant sociopolitical policies and pragmatic educational guidelines for policy makers to solve some of its problems within the Nigerian landscape and beyond. This was a cross-sectional study conducted in April 2000, at Oranfe community in Ile-Ife, South West, Nigeria, which has an estimated population of 5250 inhabitants. We used the survey method with the aid of a well-structured questionnaire. One hundred and eighty residents of the community were sampled as our subjects for this study. We used the cluster random sampling technique. The main outcome measures were the sociodemographic characteristics of the respondents, knowledge, attitude with perceived solutions to the problems of abortion and relationship of the sociodemographic factors to respondents' knowledge and attitude. The respondents were highly literate, as only 18(11.04%) had no formal education. Eighty-five (52.79%) had good knowledge of abortion while 45 (27.95%) and 31 (19.25%) had fair and poor knowledge, respectively. Thirty-eight (24.05%) respondents felt that the solution to the problems of induced abortion can be obtained through its legalisation; 31 (19.62%) respondents believed that the solution lies in liberalising laws on abortion; provision of safe abortion services was suggested by 30 (18.98%) respondents. One hundred and seven (66.88%) felt that legalisation of abortion will increase its practice while 53 (31.12%) felt that such legalisation will not increase the practice. Similarly, 55 (34.37%) of the respondents emphasised that legalisation would reduce the problems of induced abortion compared with 82 (51.25%) who felt otherwise. One hundred and twenty (73.61%) of the respondents did not believe that the position of the law in Nigeria can stop the practice of induced abortion. Solving the problems of induced abortion in Nigeria requires pragmatic and non-hypocritical sex educational policies, which are widely embracing to sensitise people in the community through public enlightenment programmes. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 185042.Article de périodique
Thonneau P.; Goyaux N.; Goufodji S.; Sundby J.
Abortion and maternal mortality in Africa
2002 - New England Journal of Medicine, 347(24), p. 1984-1985
Mots clés : mortalité maternelle
Pays / Régions : AfriqueRésumé : no abstract
Article de périodique
Dickson Tetteh K.; Billings D.L.
Abortion care services provided by registered midwives in South Africa
2002 - International Family Planning Perspectives, 28(3), p. 144-150
Mots clés : avortement; évaluation; service de santé; enquête; santé; sage-femme; personnel de santé; soin post-abortum; programme; collecte; soin; éducation; planning familial; contraception d'urgence; contraception postcoitale; personnel de santé; méthodologie
Pays / Régions : Afrique du Sud; Afrique; Afrique Subsaharienne; Afrique Anglophone; Afrique AustraleRésumé : South Africa's Choice on Termination of Pregnancy Act, which took effect in 1997, legalized abortion and stipulated that registered midwives can perform abortions for women with pregnancies of no more than 12 weeks' gestation. A program was initiated to train registered midwives throughout South Africa to provide abortion services at primary care facilities. From October 1999 through January 2000, an evaluation was conducted at 27 public health care facilities in South Africa's nine provinces to assess the quality of care provided by midwives who had been trained and certified to provide abortion services. Data were collected by observing abortion procedures and counseling sessions, reviewing facility records and patients' charts, and interviewing patients and certified midwives. Of 96 abortion procedures performed by 40 midwives, 85 involved manual vacuum aspiration. Midwives' clinical practice was rated "good" in 75% of the procedures. No complications occurred during abortion procedures or as a result of the procedures, and no abortion clients died. Midwives consistently provided women with contraceptive counseling after the abortion, and most clients (89%) received a contraceptive method before leaving the facility. The injectable was the only method that was available at all facilities; of the 90 clients who were interviewed about the contraceptive method they reviewed after their abortion, 75% had received this method. Few had received condoms (1%). Midwives can provide high-quality abortion services in the absence of physicians. Training in abortion care should be systematically integrated into midwives' basic training. This training should use postabortion counseling as an opportunity to inform women about dual protection from unwanted pregnancy and sexually transmitted infections. (author's)
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2814402.html.Article de périodique
Hord C.E.; Xaba M.
Abortion law reform in South Africa: report of a study tour, May 13-19, 2001
2002
Mots clés : étudiant; scolarisation; loi; facteur politique; service de santé; méthodologie; avortement; contraception d'urgence; contraception postcoitale; planning familial; soin; santé
Pays / Régions : Afrique du Sud; Afrique Anglophone; Afrique; Afrique Australe; Afrique SubsaharienneRésumé : This report attempts to summarise some of the main strategies suggested and lessons described by the South African study tour hosts. Its objectives therefore are: to share experiences and lessons learned about South Africa's abortion law reform process with regard to: the legal reform process itself and the implementation of the law once it was passed. To be a useful reference guide and advocacy tool for the participants in the study tour, as well as others interested in changing abortion laws. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 173677.Ouvrage
United Nations; Population Division
Abortion Policies. A global review - vol III Oman to Zimbabwe
2002 - New York: United Nations, 241 p.
Mots clés : politique; programme; fécondité; mortalité; contraception d'urgence; contraception postcoitale; planning familial; population; facteur démographiqueRésumé : This is the third of three volumes presenting a country-by-country examination of national policies concerning abortion. This volume concerns countries in alphabetical order from Oman to Zimbabwe. The information regards abortion policy, the fertility and mortality context in which abortion policy has been developed, and selected statistics on induced abortion. (ANNOTATION)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - IND RH5C099.Article de périodique
Calves A.E.
Abortion risk and decisionmaking among young people in urban Cameroon
2002 - Studies in Family Planning, 33(3), p. 249-260
Mots clés : méthodologie; enquête; ville; résidence; adolescence; adolescent; jeune; adolescent; femme; décision; avortement; risque; étudiant; scolarisation; analyse; facteur géographique; population; âge; facteur démographique; comportement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Cameroun; Afrique Centrale; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : This study examines the use of induced abortion among Cameroonian adolescents and young women, based on biographical data collected in 1997 among young women and men residing in Yaounde. Results suggest a high prevalence of abortion during adolescence and early adulthood (35% of all pregnancies reported). Although most clandestine abortions were performed by a physician or a nurse, the prevalence of abortion performed by nonmedical personnel or using unsafe methods is still high, and postabortion health complications are reported for about one-fourth of all abortions. Logistic regression models are used to examine the effect of women's, partners', and relationships' characteristics at the time of pregnancy on the odds that a pregnancy will be terminated through abortion. The analysis shows a significant effect of school enrollment, parity, and stability and social acknowledgment of the sexual relationship on the risk of having an abortion. Young men's involvement in decisions and their motivations concerning abortion are also examined. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 172105.Article de périodique
Buga G.A.
Attitudes of medical students to induced abortion
2002 - East African Medical Journal, 79(5), p. 259-262
Mots clés : méthodologie; enquête; étudiant médecine; religion; avortement; attitude; croyance; étudiant; scolarisation; éducation; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement; culture
Pays / Régions : Afrique du Sud; Afrique Anglophone; Afrique; Afrique Australe; Afrique SubsaharienneRésumé : Unsafe abortion causes 13% of maternal deaths worldwide. Safe abortion can only be offered under conditions where legislation has been passed for legal termination of unwanted pregnancy. Where such legislation exists, accessibility of safe abortion depends on the attitudes of doctors and other health care workers to induced abortion. Medical students as future doctors may have attitudes to abortion that will affect the provision of safe abortion. Little is known about the attitudes of South African medical students to abortion. A cross-sectional analytic study involving the self-administration of an anonymous questionnaire was conducted to assess sexual practices and attitudes of medical students to induced abortion and to determine some of the factors that may influence these attitudes. The questionnaire was administered to medical students at a small, but growing, medical school situated in rural South Africa. The main outcome measures include demographic data, sexual practices and attitudes to induced abortion. 247 out of 300 (82.3%) medical students responded. Their mean age was 21.81 +or- 3.36 (standard deviation [SD]) years, and 78.8% were Christians, 17.1% Hindus and 2.6% Muslims. Although 95% of the respondents were single, 68.6% were already sexually experienced, and their mean age at coitarche was 17.24 +or- 3.14 (SD) years. Although overall 61.2% of the respondents felt abortion is murder either at conception or later, the majority (87.2%) would perform or refer a woman for abortion under certain circumstances. These circumstances, in descending order of frequency, include: threat to mother's life (74.1%), in case of rape (62.3%), the baby is severely malformed (59.5%), threat to mother's mental health (53.8%) and parental incompetence (21.0%). Only 12.5% of respondents would perform or refer for abortion on demand, 12.8% would neither perform nor refer for abortion under any circumstances. Religious affiliation and service attendance significantly influenced some of these attitudes and beliefs. Although many of the medical students personally felt abortion is murder, the majority are likely to perform or refer to patients for abortion under certain circumstances; only about a 10th are likely to perform or refer patients for abortion on demand. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 172849.Article de périodique
Sule Odu A.O.; Olatunji A.O.; Akindele R.A.
Complicated induced abortion in Sagamu, Nigeria
2002 - J Obstet Gynaecol, 22(1), p. 58-61
Mots clés : avortement
Pays / Régions : NigeriaRésumé : A review of cases of induced abortion managed at Ogun State University Teaching Hospital, Sagamu from January 1988 to December 1997 is presented. One hundred and two cases were treated for various complaints and complications of induced abortion during the period of review. The findings in this series further highlight the urgent need to eliminate or reduce substantially the factors responsible for septic induced abortion.
Source : source : J Obstet Gynaecol.Article de périodique
Fawole A.A.; Aboyeji A.P.
Complications from unsafe abortion: presentations at Ilorin, Nigeria
2002 - Niger J Med, 11(2), p. 77-80
Mots clés : avortement
Pays / Régions : NigeriaRésumé : This is a retrospective evaluation of the 220 patients that presented at the University of Ilorin Teaching Hospital (UITH) with complications from unsafe abortions between 1st January, 1986 and 31st December 1999. History of previous induced abortion was agreed to by 80.5%, of patients while only 6.8% had previous contraceptive use. Sepsis 204(92.7%) with abscess formation in 64.9%, visceral injuries 62(28.2%) with haemoperitoneum in 25.9% and maternal mortality was recorded in 26.4% of the series. Findings are comparable with previous studies from this centre between 1981 and 1985 and with reports from other parts of the world. The need for behavioural change by the society and the re-training of physicians on post-abortal care is emphasized.
Source : SOURCE : Nigerian Journal of Medicine.Article de périodique
Oye Adeniran B.A.; Umoh A.V.; Nnatu S.N.
Complications of Unsafe Abortion: A Case Study and the Need for Abortion Law Reform in Nigeria
2002 - Reproductive Health Matters, 10(19), p. 18-21
Mots clés : avortement à risque; avortement clandestin; mortalité maternelle; offre; praticien; prestataire
Pays / Régions : NigeriaRésumé : Complications of unsafe abortion account for 30-40% of maternal deaths in Nigeria. This paper reports a case of unsafe abortion by dilatation and curettage, carried out by a medical practitioner in a private clinic on a 20-year-old single girl in Lagos, Nigeria. The girl was 16 weeks pregnant. She suffered complications consisting of perforation of the vaginal wall through the utero-vesical space into the abdominal cavity with gangrenous loops of small intestine herniating through it. Information was obtained from her case notes and the operating theatre register. She had a resection and anastomosis of the small intestine and had to remain in hospital, where she made a full recovery, for two weeks. Unsafe abortion is fraught with many complications, including pelvic sepsis, septicaemia, haemorrhage, renal failure, uterine perforation and other genital tract injuries, and gastro-intestinal tract injuries. Where expert, emergency treatment for these is not available, women die. Unsafe abortion procedures, untrained abortion service providers, restrictive laws and high morbidity and mortality from abortion tend to occur together. We advocate for a review of the existing restrictive laws in Nigeria in order to reduce the high morbidity and mortality from unsafe abortion.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Geelhoed D.W.; Nayembil D.; Asare K.; Schagen van Leeuwen J.H.; van Roosmalen J.M.
Contraception and induced abortion in rural Ghana
2002 - Tropical Medicine and International Health, 7(8), p. 708-716
Mots clés : méthodologie; enquête; analyse; prévalence; rural; résidence; communauté; contraception; méthode contraceptive; avortement; prévalence contraceptive; étudiant; scolarisation; collecte; mesure; facteur géographique; population; résidence; planning familial; contraception d'urgence; contraception postcoitale
Pays / Régions : Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This article describes the results of a community-based survey on birth control in a rural district in western Ghana. Structured interviews with 2179 women and men aged 15-49 years were used to study the prevalence of contraceptive methods and induced abortion. In addition, the influence of induced abortion on reported fertility in relation to residence and education was analyzed. The results show that 59.8% had used a contraceptive method at some time in life, while use of induced abortion was reported by 22.6% of respondents. Prevalence of ever-use of any method to avoid childbirth, contraception and/or induced abortion was 67.1%. Urban residence and higher education were associated with more induced abortions and higher use of contraceptive methods. Differences in use of induced abortion were partly responsible for the education and residence-related changes in fertility. Induced abortion needs to be considered when discussing methods in use to avoid childbirth in developing countries. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 170677.Article de périodique
Adewole L.F.; Oye Adeniran B.A.; Iwere N.; Oladokun A.; Gbadegesin A.; Babarinsa L.A.
Contraceptive usage among abortion seekers in Nigeria
2002 - West Afr J Med, 21(2), p. 112-114
Mots clés : contraception; méthode contraceptive
Pays / Régions : NigeriaRésumé : A study on contraceptive usage among abortion seekers in 150 randomly selected health institutions in the most and the least urbanized states of the health zone B representing the South Western states of Nigeria was conducted over a period of 2 months. There were 1839 abortion seekers during the period.
Source : Source west afr med j.Article de périodique
Desgrées du Loû A.; Msellati P.; Viho I.; Yao A.; Yapi D.; Kassi P.; Welffens Ekra C.; Mandelbrot L.; Dabis F.
Contraceptive use, protected sexual intercourse and incidence of pregnancies among African HIV-infected women. DITRAME ANRS 049 project, Abidjan 1995-2000
2002 - International Journal of STD AIDS, 13(7), p. 462-468
Mots clés : VIH; sida; contraception; méthode contraceptive
Pays / Régions : Cote d'IvoireRésumé : The aim of this paper is to describe the adherence of African HIV+ women to the counselling provided after announcement of the result of the HIV test during pregnancy, focusing on early weaning to reduce post-natal transmission, protected sexual intercourse to avoid sexual transmission, and contraceptive use to avoid unexpected pregnancies. In 1999- 2000, a questionnaire on sexual and reproductive behaviours was administered to 149 HIV+ women followed in post-partum, informed and counselled in the ANRS 049 DITRAME project in Abidjan. Cote d'Ivoire. Duration of breastfeeding, post-partum amenorrhea and abstinence, contraceptive use and condom use were measured. Incidence of pregnancies during the first 24 months post partum was estimated and modelled by a Cox regression model. Average duration of breastfeeding was 7.9 months, average duration of post partum abstinence was 12.0 months, and 39% of women used contraceptives at the time of the survey. Frequency of condom use was 13%. Incidence of pregnancies was 16.5 per 100 women-years at risk. Half of these pregnancies were not desired and a third were terminated by induced abortion. The significant determinants of the pregnancy occurrence were the death of the previous child, the cessation of breastfeeding, the cessation of the post partum abstinence, and higher education. In conclusion, if counselling on early weaning can be followed by the HIV+ women, it is not easily the case for condom and contraceptive use. Hence, pregnancy incidence in the post-partum follow-up was high. The main strategy of these HIV+ women to avoid unexpected pregnancies as well as sexual transmission of HIV seems to be an increase of the duration of post-partum abstinence. The most educated women who cannot easily adopt this strategy are particularly exposed to unwanted pregnancies.
Source : source : International Journal of STD AIDS.Ouvrage
Bajos N.; Ferrand M.; Equipe GYNE
De la contraception à l'avortement . Sociologie des grossesses non prévues
2002 - Paris: Inserm, 345 p.
Mots clés : contraception; méthode contraceptive
Pays / Régions : France
Source : source : Inserm.Article de périodique
Murthi M.
Fertility Change in Asia and Africa
2002 - World Development, 30(10), p. 1769-1778
Pays / Régions : Inde; AfriqueRésumé : There have been profound changes in fertility rates in Asia and Africa in the past two to three decades. The availability of new data allows a closer examination of fertility trends and underlying causes than has hitherto been possible. The papers examine the role of different explanatory factors in lowering fertility, including female education, declines in child mortality, urbanization, and the spread of mass media and "modern" consumer culture.
Source : source : World Development.Article de périodique
Guillaume A.; Desgrées du Loû A.
Fertility regulation among women in Abidjan, Cote d'Ivoire: contraception, abortion or both? (version en français : Limitation des naissances parmi les femmes d'Abidjan en Cote d'Ivoire: contraception, avortement ou les deux?, perspectives internationalles sur la planning familial, n° spécial 2002: 4-11)
2002 - International Family Planning Perspectives, 28(3), p. 159-166
Mots clés : enquête; contraception; méthode contraceptive; fécondité; prévalence; méthodologie; femme; avortement; facteur démographique; planning familial; contraception d'urgence; contraception postcoitale; mesure; population; étudiant; scolarisation
Pays / Régions : Cote d'Ivoire; Afrique; Afrique Subsaharienne; Afrique Francophone; Afrique de l'OuestRésumé : In Cote d'Ivoire, where contraceptive prevalence is low, abortion is thought to play an important role in the current fertility decline. However, data on abortion, which is illegal, are scarce. A retrospective survey on abortion and contraceptive practices was conducted in 1998 among 2400 women who attended four general health centers in Abidjan. Multinomial logistic regression was performed to analyze the independent effects of social and demographic variables on the odds that women would adopt one of three fertility regulation behaviors instead of doing nothing at all. Results show that 40% of women reported controlling their fertility through contraceptive use alone, 30% through reliance on both contraception and abortion and 3% through abortion alone; some 27% did nothing to control fertility. Muslims had consistently lower odds than Christians of adopting any of the three behaviors instead of doing nothing (odds ratios (OR), 0.2-0.5). Being unmarried and better educated were associated with significantly elevated odds of adopting each of the three behaviors (OR, 1.4-33.8). Finally, the odds of using abortion alone were significantly higher among women younger than 25 than among those aged 25-34 (2.0). In conclusion, the relationship between abortion and contraception is highly complex. Whereas women who do not have access to contraceptives or who experience method failure often resort to abortion, abortion can also trigger subsequent reliance on contraception. (author's)
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2815902.html and http://www.agi-usa.org/pubs/journals/2800402fr.pdf.Article de périodique
Geelhoed D.; Nayembil D.; Asare K.; van Leeuwen J.H.; van Roosmalen J.M.
Gender and unwanted pregnancy: a community-based study in rural Ghana
2002 - J Psychosom Obstet Gynaecol, 23(4), p. 249-255
Mots clés : avortement
Pays / Régions : GhanaRésumé : This study investigates attitudes concerning unwanted pregnancies in a rural district of western Ghana. Structured questionnaires were used to interview men and women between 15 and 49 years of age (n = 2179) to measure the prevalence of unwanted pregnancy, how often it led to induced abortion and to establish the reasons why a pregnancy was considered unwanted. . Pregnancies perceived by women as unwanted ended more often in an induced abortion than those unwanted by men. Reproductive health programs need to make contraceptives available, accessible and acceptable for both women and men. More research is needed to facilitate a clear understanding of the impact of gender on unwanted pregnancy and its prevention.
Source : source :J Psychosom Obstet Gynaecol.Article de périodique
Blanc A.K.; Grey S.
Greater than expected fertility decline in Ghana: untangling a puzzle
2002 - Journal of Biosocial Science, 34(4), p. 475-495
Mots clés : méthodologie; enquête; analyse; transition fécondité; enquête démographique et de santé; EDS; fécondité; prévalence contraceptive; contraception; méthode contraceptive; mariage; état matrimonial; sexualité; déterminant fécondité; déterminant; étudiant; scolarisation; population; facteur démographique; taux fécondité; taux natalité; planning familial; nuptialité; état matrimonial; mariage; comportement; contraception d'urgence; contraception postcoitale
Pays / Régions : Ghana; Afrique; Afrique de l'Ouest; Afrique SubsaharienneRésumé : This study examines fertility decline that is larger than expected on the basis of recorded increases in contraceptive prevalence in Ghana. The primary sources of data are three Demographic and Health Surveys conducted in the country in 1988, 1993 and 1998. First, the trend in fertility and contraceptive prevalence in Ghana is considered and compared with the trend that would be expected on the basis of prior research. Next, an attempt is made to uncover the explanation behind this unexpected trend. Measures of the quality of the survey data are looked at, as well as trends in the proximate determinants of fertility: contraceptive use, marriage and sexual activity, postpartum insusceptibility and induced abortion. Finally, evidence is presented that couples adjust their coital frequency in accordance with their fertility preferences, behavior that would influence fertility rates but would not be captured by conventional measures of the proximate determinants of fertility. (author's) (© 2002 Cambridge University Press)
Source : source : journal of biosocial science http://titles.cambridge.org/journals/journal_catalogue.asp?historylinks=ALPHAmnemonic=JBS.Congrès
Guillaume A.; Desgrées du Loû A.; Zanou B.
Introduction
2002 - Santé de la reproduction en AfriqueSéminaire International Santé de la Reproduction en Afrique, Abidjan (CI) 1999/11/9-12, Abidjan (CI), ENSEA, p. 1-12 p.
Mots clés : adolescence; adolescent
Source : Source Ceped : http://ceped.cirad.fr.Congrès
Guillaume A.
L'avortement en Afrique : une pratique fréquente chez les adolescentes?
2002 - Enfants d'aujourd'hui. Diversité des contextes, pluralité des parcours, Dakar, 12 p.Résumé : L'avortement est un sujet mal connu en Afrique : illégal dans une majorité de pays africains, rares sont les données disponibles sur ce sujet. Ce problème de l'avortement se pose avec une acuité particulière chez les adolescentes. Leur sexualité n'est pas toujours socialement reconnue et admise, et ainsi leur accès à la planification familiale est dans certains pays difficile voire impossible : les programmes étant parfois " réservés " aux femmes mariées. La prévalence contraceptive des adolescentes est faible et repose sur des méthodes peu efficaces, de plus ces femmes n'ont pas toujours une autonomie suffisante pour gérer leur sexualité et demander ou imposer à leur partenaire le recours à une méthode préventive aussi bien pour les infections sexuellement transmissibles que les grossesses. L'avortement est la réponse à une grossesse non prévue et est utilisée parfois à la place de la contraception : sa fréquence est variable selon les pays mais les études sur les complications des avortements attestent de l'ampleur de ce phénomène chez les jeunes femmes (auteur)
Source : Source : Ceped.Article de périodique
Buchmann E.J.; Mensah K.; Pillay P.
Legal termination of pregnancy among teenagers and older women in Soweto, 1999-2001
2002 - S Afr Med J, 92(9), p. 729-731
Mots clés : loi; adolescence; adolescent
Pays / Régions : Afrique du SudRésumé : Legal termination of pregnancy (TOP) was introduced in South Africa in 1996. No data are available to relate the numbers of TOPs to the total number of pregnancies in specific health regions. .
Source : source : S Afr Med J.Chapitre d'ouvrage
Gastineau B.
Légalisation de l'avortement et planification familiale : l'expérience tunisienne
2002 - In A. Guillaume, Desgrees du Loû, A., Zanou B, Koffi N. (Ed.) Santé de la Reproduction en Afrique, p. 243-264. Abidjan, Côte d'Ivoire:
Mots clés : législation
Source : Source : Ceped http://ceped.cirad.fr.Chapitre d'ouvrage
Gautier A.
Les droits reproductifs en Afrique sub-saharienne
2002 - In A. Guillaume, Desgrees du Loû, A., Zanou B, Koffi N. (Ed.) Santé de la Reproduction en Afrique, p. 77-100. 9-12 novembre 1999, ENSEA, Abidjan, Côte d'Ivoire: Abidjan, Côte d'Ivoire
Mots clés : législation
Source : Source : Ceped http://ceped.cirad.fr.Article de périodique
Kodio B.; de Bernis L.; Ba M.; Ronsmans C.; Pison G.; Etard J. F.
Levels and causes of maternal mortality in Senegal
2002 - Tropical Medicine International Health, 7(6), p. 499-505
Mots clés : méthodologie; décès; enquête; mortalité maternelle; femme; autopsie; service de santé; statistique; population; collecte; mortalité; facteur démographique; soin de santé primaire; soin; santé; mesure
Pays / Régions : Sénégal; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : OBJECTIVES: To report the findings of a direct, community- based, assessment of maternal : The objective of this study is to report the findings of a direct, community-based, assessment of maternal mortality and medical causes of death using verbal autopsy in three unique cohorts in rural Senegal. Data were collected from ongoing demographic surveillance systems. The authors obtained records of all deaths and births in women of age 15-49 over a period of 14 years in Niakhar, 10 years in Bandafassi and 13 years in Mlomp. Relatives of all women who died were interviewed using a standard questionnaire. Causes of death were assigned by three physicians independently. Maternal deaths were defined according to the 9th and 10th revisions of the International Classification of Diseases. The maternal mortality ratio was similar in Mlomp [436/100,000 live births (95% confidence interval 209-802)] and Niakhar [516/100,000 (413-636)] but significantly higher in the more remote area of Bandafassi [852 (587-1196)] [relative risk compared with Niakhar 1.6 (1.0-2.4)]. Two-thirds of the maternal deaths were from direct obstetric causes, hemorrhage being the most common. Abortion was rare. Demographic surveillance systems are useful tools for the measurement of maternal mortality provided special studies are carried out to arrive at the levels and causes of maternal death. The estimates of maternal mortality reported here are lower than those published by the WHO and UN Children's Fund but remain extremely high, particularly in the very remote areas with very limited health infrastructure, where as many as 1 in 19 women may be expected to die as a consequence of childbirth. (author's)French Abstract: L'objectif de cette étude est de rapporter les résultats d'une évaluation directe, à l'échelon de la collectivité, sur la mortalité maternelle et les causes médicales de décès à l'aide d'une autopsie verbale dans trois cohortes uniques du Sénégal rural. Les données de systèmes surveillance démographique permanents furent recueillies. Les auteurs ont obtenu les dossiers de tous les décès et toutes les naissances de femmes âgées de 15 à 49 sur une période de 14 ans à Niakhar, de 10 ans à Bandafassi, et de 13 ans à Mlomp. Les parents de toutes femmes décédées furent interrogés à l'aide d'un questionnaire standard. Les causes de décès furent assignées par trois médecins indépendamment les uns des autres. Les décès maternels furent définis conformément aux 9ème et 10ème révisions de la Classification internationale des maladies. Le quotient de mortalité maternelle était similaire à celui de Mlomp [436/100 000 naissances vivantes(intervalle de confiance de 95 %, 209 à 802)] et Niakhar [516/100 000 (413 à 636)] mais nettement plus élevé dans le région la plus reculée de Bandafassi [852 (587 à 1196)] [risque relatif comparé à Niakhar 1,6 (1 à 2,4)]. Deux tiers des décès maternels étaient directement liés à des causes obstétriques, l'hémorragie étant la plus courante. Le taux d'avortement était rare. Les systèmes de surveillance démographique sont des outils utiles pour mesurer la mortalité maternelle, pourvu que des études spéciales soient effectuées afin d'arriver aux taux et causes du décès maternel. Les estimations de mortalité maternelle rapportées ci-après sont inférieures à celles publiées par l'OMS et le Fonds des Nations Unies pour l'enfance, mais elles demeurent extrêmement élevées, en particulier dans les régions très reculées pourvues d'une infrastructure sanitaire très limitée, où l'on peut anticiper le décès des suites d'une naissance de 1 femme sur 19. (de l'auteur)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 169201.Article de périodique
Berer M.
Making Abortion a Woman's Right Worldwide
2002 - Reproductive Health Matters, 10(19), p. 1-8Résumé : no abstract
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Berer M.
Making Abortions Safe: A Matter of Good Public Health Policy and Practice
2002 - Reproductive Health Matters, 10(19), p. 31-44
Mots clés : loi; offre; praticien; prestataireRésumé : Globally, abortion mortality constitutes at least 13% of maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing abortion mortality and morbidity in countries where they remain high is a matter of good public health policy, based on good medical practice, and an important part of initiatives to make pregnancy safer. This paper examines the changes in policy and health service provision required to make abortions safe. It is based on a wide-ranging review of published and unpublished sources. In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost and counselling issues. The transition from unsafe to safe abortions demands: changes at national policy level; abortion training for service providers; the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. Public awareness that abortion services are available is a crucial element of this transition, particularly among adolescent and single women, who tend to have less access to reproductive health services generally.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Thèse
Rossier C.
Measure and meaning of induced abortion in rural Burkina Faso
2002 - Demography, UC Berkeley., UC Berkeley., Berkeley,
Pays / Régions : AfriqueRésumé : There is no recognized method to date to estimate the incidence of illegal abortion. Illegal abortion is an important cause of mortality in developing countries; an estimation tool will help promote policies to reduce abortion mortality. In demographic research, an estimation technique will help understand the role of abortion during fertility declines. In this dissertation, I develop a new survey method to estimate the incidence of illegal abortion, the Third Party Reporting (TPR) method. This technique asks survey respondents to report the abortions occurring in their social networks. I develop two versions of the TPR method: one where respondents report the abortions of the women who confide in them, and one where respondents report the abortions occurring in their community. I tested in one village of the Bazega province, Burkina Faso, three survey abortion estimation methods against an abortion rate obtained using ethnographic techniques (15.3 / 1000 women 15-49). The residual and the self-reporting methods yielded unsatisfactory estimates. The TPR method, applied in its "community" version, gave an estimate that was within 80% of the ethnographic estimate. However, I met difficulties in matching abortion cases when applying the "community" version of the TPR method. The "confidantes" version of the TPR should be further developed. Using the TPR method, I estimated the rate of induced abortion in nine villages in Bazega. More developed villages were characterized by lower fertility levels and higher abortion rates. These results substantiate demographic theories on the role of abortion at the beginning of fertility declines.To better measure abortion, I investigated its local meaning. I found that abortion has an ambivalent meaning in Bazega, condemned as the marker of dishonorable sexual conduct, and tolerated as a means of avoiding shame. I found that different cultural models of birth control coexist in Bazega today; cultural change is progressive, socially differentiated, and conflicted. I found that new discourses oppose contraception and abortion, as do international family planning discourses; global and local visions of birth control are linked. Finally, I found that local birth control strategies in Bazega are not focused on modern contraception and the limitation of births
Source : source : Ceped.Chapitre d'ouvrage
Guillaume A.; Desgrées du Loû A.
Planification familiale à Abidjan : contraception et/ou avortement ? Une étude auprès de consultantes de 4 formations sanitaires urbaines
2002 - In A. Guillaume, Desgrees du Loû, A., Zanou B, Koffi N. (Ed.) Santé de la reproduction en Afrique, p. 267-296. Abidjan: ENSEA, FNUAP, IRD
Source : Source : Ceped http://ceped.cirad.fr.Article de périodique
Varga C.A.
Pregnancy termination among South African adolescents
2002 - Studies in Family Planning, 33(4), p. 283-298
Mots clés : méthodologie; enquête; focus group; enquête; adolescence; adolescent; grossesse adolescente; grossesse; ville; résidence; rural; résidence; avortement; perception; connaissance, attitude; pratique; CAP; décision; étudiant; scolarisation; collecte; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement
Pays / Régions : Afrique du Sud; Afrique Anglophone; Afrique; Afrique Australe; Afrique SubsaharienneRésumé : Although African adolescents' risk of undergoing abortion and of related health complications is well-documented, little is known about the procedure's prominence in their lives and the pathways that lead to their reliance upon it. This study investigates abortion dynamics among male and female Zulu adolescents in KwaZulu/Natal, South Africa. It explores the role of abortion in young people's sexual and reproductive experience, its acceptability, the reasons and likelihood of young people's choosing abortion, and the commonly used methods of pregnancy termination. The study, a rural-urban comparison using focus-group discussions, narrative workshops, and role playing, involved surveys and in-depth interviews. Factors contributing to the commonplace nature of backstreet procedures among adolescents include: social stigma, inadequate knowledge of the legal status of abortion, and a complex group decision making process. Young people invoke "relative moralities" concerning adolescent abortion, recognizing and condoning it on a context-specific basis. Age, gender, and geographic differences are examined. The methodological triangulation used offers the opportunity for alternative theoretical and methodological approaches to research on abortion-related issues. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 174580.Article de périodique
Jewkes R.; Brown H.; Dickson Tetteh K.; Levin J.; Rees H.
Prevalence of morbidity associated with abortion before and after legalisation in South Africa
2002 - BMJ. British Medical Journal, 324(7348), p. 1252-1253
Mots clés : méthodologie; étudiant; scolarisation; prévalence; médicament; loi; morbidité; mesure; avortement; contraception d'urgence; contraception postcoitale; planning familial; maladie; complication
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In South Africa, the Choice in Termination of Pregnancy Act, which allows abortion on request up to 20 weeks' gestation, has been legalized. Since its legalization in 1997, 40,000 legal abortions have been performed annually. In this paper, the impact of legislative change on morbidity and medical management by repeating the 1994 study of morbidity due to incomplete abortion among patients presenting to public hospitals in 2000 was examined. Data were collected over different 3-week periods between May and August on all women presenting to the randomly selected public hospitals (47 hospitals from the sampling frame of all public hospitals in the nine provinces of South Africa responsible for treating women with gynecological problems in 2000). A data capture sheet for each woman was completed from the hospital records by a healthcare staff in which three clinical severity categories were used for data analysis and interpretation. The Rao Scott F test was used to compare the categorical variables with the 1994 study. Overall, findings showed that the legalization of abortion in South Africa immediately decreased morbidity but the magnitude was not substantial. The trend towards lower technology partially reflects success of training programs for induced abortion; however, the findings suggest that further structured training in the use of manual vacuum aspiration with paracervical block and appropriate use of antibiotics and misoprostol would be substantial.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 168163.Thèse
Mouvagha Sow M.
Processus matrimoniaux et procréation à Libreville, Gabon
2002 - UFR de sciences sociales et administration, Université Paris X, Nanterre, 587
Source : source : Université Paris X.Article de périodique
Songane F.F.; Bergstrom S.
Quality of registration of maternal deaths in Mozambique: a community-based study in rural and urban areas
2002 - Social Science Medicine, 54(1), p. 23-31
Mots clés : mortalité maternelle; enquête
Pays / Régions : MozambiqueRésumé : Maternal mortality is an important indicator used to assess the level of development of a country and particularly the coverage of health services. In Africa where the maternal mortality ratios are about 100 times higher than those of developed countries the situation is even worse due to problems of underregistration. In Mozambique the figures officially used are derived from the data of some hospitals in the main cities. This leaves out the 60% of pregnant women who do not attend health facilities. It was against this background that the present study was designed to be a prospective community-based study carried out in the central region of Mozambique involving a population of 207,369 inhabitants. The study covered a 12-month period, from 01/08/96 to 31/07/97 and found 214 deaths among women in reproductive age (15-49 yr) of whom 40 were classified as maternal deaths.Gross underregistration was revealed, as the health institutions failed by 86% in recording maternal deaths, the same happening with other official sources, like the Civil Register and the Funeral Services registering only 9% of the maternal deaths.This kind of study is however complex and labour intensive and a practical way of monitoring has to be found; for the region where the study took place close collaboration with private cemeteries appears to be a way to be further explored.
Source : Source : Social Science Medicine.Chapitre d'ouvrage
Amegee L.K.
Recours à l'avortement provoqué en milieu scolaire au Togo : mesure et facteurs du phénomène
2002 - In A. Guillaume, Desgrees du Loû, A., Zanou B, Koffi N. (Ed.) Santé de la reproduction en Afrique, p. 297-320. Abidjan, Côte d'Ivoire: ENSEA, FNUAP, IRD
Mots clés : adolescence; adolescent
Pays / Régions : Togo
Source : Source : Ceped http://ceped.cirad.fr.Article de périodique
Johnson B.R.; Ndhlovu S.; Farr S.L.; Chipato T.
Reducing unplanned pregnancy and abortion in Zimbabwe through postabortion contraception
2002 - Studies in Family Planning, 33(2), p. 195-202
Mots clés : avortement
Pays / Régions : ZimbabweRésumé : In many countries, women treated for complications from spontaneous or unsafely induced abortion lack access to contraceptive services. As a result, many of them soon have a subsequent unplanned pregnancy or a repeat abortion, placing their health at increased risk. This report presents the results of a prospective intervention study on postabortion family planning conducted in the two largest public hospitals in Zimbabwe. Women at Harare Central Hospital, in the capital, received a postabortion family planning intervention, and Mpilo Central Hospital, in Bulawayo, served as the control site. The study cohort was 982 women, 527 of whom were followed for a 12-month period. During the follow-up period, significantly more women used highly effective methods of contraception, significantly fewer unplanned pregnancies occurred, and fewer repeat abortions were performed at the intervention site than at the control site. These results offer compelling evidence that ward-based contraceptive services provided to women treated for incomplete abortion can significantly reduce subsequent unplanned pregnancies. The results also suggest that postabortion family planning services can reduce the incidence of repeat abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html.Article de périodique
de Bruyn M.
Reproductive choice and women living with HIV AIDS
2002
Mots clés : enquête; VIH; femme; sida; grossesse; complication grossesse; avortement; santé de la reproduction; décision; programme de santé; collecte; méthodologie; maladie; maladie; complication; contraception d'urgence; contraception postcoitale; planning familial; fécondité; population; facteur démographique; santé; comportement; politique; programme
Pays / Régions : Australie; Inde; Kenya; Afrique du Sud; Thaïlande; Océanie; Asie du Sud; Asie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Afrique Australe; Asie du Sud EstRésumé : One area in which stigma and discrimination affect women living with HIV/AIDS (WHA) is reproductive health. This report summarizes available information concerning barriers and discrimination that WHA face in exercising their full sexual and reproductive rights concerning pregnancy. It is based on an extensive review of the literature and interviews with key informants in Australia, India, Kenya, South Africa and Thailand. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 175372.Article de périodique
Gebreselassie H.; Fetters T.
Responding to unsafe abortion in Ethiopia: a facility-based assessment of postabortion care services in public health sector facilities in Ethiopia
2002
Mots clés : méthodologie; mortalité maternelle; avortement; soin post-abortum; évaluation; mortalité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé; programme
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : In Ethiopia, maternal deaths associated with complications of pregnancy and delivery are among the highest in the world. Several studies indicate that unsafe abortion accounts for up to 25-35% of these maternal deaths. The burden of unsafe abortion on women, their families and communities, and on the limited resources of the Ethiopian health system is enormous. In order to explore health systems issues and determine reliable baseline figures prior to program expansion, Ipas Ethiopia collaborated with the Regional Health Bureaus from July-September 2000, to conduct a cross-sectional postabortion care (PAC) assessment in three regions: Oromia, Amhara and Addis Ababa. The main objective of the assessment was to determine the current and future potential capacity and quality of PAC service delivery in public hospitals and health centers. A total of 120 health facilities were included in the study. The proportion of the total facilities located in each of the regions and included in the assessment is summarized in Table 1. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 170188.Publication
Guillaume A.; Desgrées du Loû A.; Zanou B.; N. K.
Santé de la Reproduction en Afrique
2002 - ENSEA, FNUAP, IRD, Abidjan, 366 p.
Mots clés : adolescence; adolescent
Source : Source : Ceped http://ceped.cirad.fr.Article de périodique
Vandecruys H.I.; Pattinson R.C.; Macdonald A.P.; Mantel G.D.
Severe acute maternal morbidity and mortality in the Pretoria Academic Complex: changing patterns over 4 years
2002 - Eur J Obstet Gynecol Reprod Biol, 102(1), p. 6-10
Mots clés : avortement; mortalité maternelle; morbidité
Pays / Régions : Afrique du SudRésumé : To compare the severe acute maternal morbidity (SAMM) and maternal mortality in the Pretoria Academic Complex for the year 2000 and the years 1997-1999. SAMM and maternal mortality was identified at daily audit meetings. The audit was performed from 1 January 2000 to 31 December 2000 and compared with the data obtained from the original 2-year audit [Br J Obstet Gynecol 105 (1998) 985].
Source : source : Eur J Obstet Gynecol Reprod Biol.Article de périodique
Lema V.M.; Mpanga V.; Makanani B.S.
Socio-demographic characteristics of adolescent post-abortion patients in Blantyre, Malawi
2002 - East African Medical Journal, 79(6), p. 306-310
Mots clés : méthodologie; enquête; adolescence; adolescent; grossesse non prévue; grossesse non désirée; sexualité; complication; soin post-abortum; patient; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; comportement; avortement; contraception d'urgence; contraception postcoitale; planning familial; programme
Pays / Régions : Malawi; Afrique Anglophone; Afrique; Afrique de l'Est; Afrique SubsaharienneRésumé : BACKGROUND: Unsafe sex, unwanted pregnancy and unsafe abortion are some of the emerging adolescent reproductive health challenges in Malawi. OBJECTIVES: To study socio-demographic characteristics of adolescent post-abortion patients and that of their male partners, with the aim of better understanding the determinants of adolescent fertility in Malawi, thus facilitating design of appropriate intervention strategies. DESIGN: A descriptive, cross-sectional study. SETTING: The Queen Elizabeth Central Hospital, Blantyre, Malawi. SUBJECTS: A total of 446 out of 465 eligible adolescents managed for incomplete abortion during the study period were enrolled from January 1st to December 31st 1997. RESULTS. Their mean age was 17.5 years (SD +/- 1.3), while that of their male partners was 22.4 years (SD +/- 3.4). The unmarried adolescents comprised 43.9% and students 38.6%. About 30.0% had attained secondary school level of education. The mean age at sexual debut was 15.7 years (SD +/- 1.75), about a year after that at menarche (14.3 years, (SD +/- 1.4)). The mean number of sexual partners they had had was 1.5 (SD +/- 0.86), the highest being 10. The index pregnancy was reportedly unwanted in 45. 1% of the total. The rate was higher among the young, single and students. They were also less likely to have informed their partners about the pregnancy or the abortion (p = 0.0001). About 52.8% of the female students were involved with fellow male students. Of the married adolescents, 4.4% reported having had extramarital affairs. CONCLUSION: There is need to design appropriate programmes to promote safe sex and reduce unwanted pregnancy and unsafe abortion with its potential sequelae among adolescents in Malawi. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 176658.Article de périodique
Machungo F.; Zanconato G.; Persson K.; Lind I.; Jorgensen B.
Syphilis, gonorrhoea and chlamydial infection among women undergoing legal or illegal abortion in Maputo
2002 - International Journal of STD and AIDS, 13(5), p. 326-330
Mots clés : méthodologie; demande; syphilis; MST; IST; gonorrhée; IST; MST; Chlamydia; IST; MST; avortement; loi; contraception d'urgence; contraception postcoitale; planning familial; maladie sexuellement transmissible; MST; IST; IST; MST; infection; complication; maladie; complication
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : The authors' objective were to compare the prevalence of sexually transmitted infections (STIs) in 103 women undergoing induced legal abortion (LA) and in 101 women with confirmed, recent illegal abortion (IA), in Maputo, Mozambique. For the purpose of this study, LA was considered the abortion provided in the Maputo Central Hospital with the approval of the Ministry of Health, and IA the one not provided through the approved facility, mentioned above. Women with IA were recruited in the outpatient gynecology ward and women with LA in the emergency gynecology ward in the Maputo Central Hospital, during the same time period. Serological tests for syphilis (rapid plasma reagin, enzyme linked immunosorbent-immunoglobulin G and fluorescent treponemal antibody absorption), gonorrhea (indirect hemagglutination) and chlamydia (microimmunofluorescence) were carried out. Direct immunofluorescence for detection of Chlamydia trachomatis antigen was done on endocervical smears from all the women. The prevalence of syphilis seropositivity in IA women is twice that of LA women (odds ratio [OR] 2.13; 95% confidence interval [CI] 0.55-9.95), with 10.9% and 4.9% respectively. Exposure to gonorrhea in these two groups is similar (OR 1.18; 95% CI 0.63-2.20), with seroprevalence of 31.1% in the LA and 34.7% in the IA group. The high titers are also similar in both groups. Serology findings for C. trachomatis indicate prevalence of seropositivity of 40.6% in the LA and 44.4% in the IA group with no significant difference (OR 1.17; 95% CI 0.64-2.13). In conclusion, STIs are highly prevalent in both IA and LA groups in Maputo. Urgent interventions are needed to reduce their prevalence and consequently their adverse consequences. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 166919.Congrès
Isiugo Abanihe I.M.; Isiugo Abanihe U.C.; Ofrey R.
Teenage reproductive health problems in the riverine areas of Nigeria : the Nembe experience
2002 - La population africaine au 21e siècle (vol. 5)Conférence Africaine de Population : la Population Africaine au 21ème Siècle, 3, Durban (ZA) 1999/12/6-10, Dakar (SN), UEPA, 393-411 p.
Mots clés : enquête; jeune; adolescent; adolescence; adolescent; déscolarisation; scolarisation; santé de la reproduction; sexualité; facteur socio-économique; étudiant; scolarisation; méthodologie; collecte; âge; population; facteur démographique; éducation; facteur économique; programme; santé; psychologie; facteur psychologique; comportement
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The research reported here was concluded in the riverine communities of Nembe in the oil-rich Bayelsa State of Nigeria in July 1996, as a baseline survey prior to the introduction of the Integrated Family-Life Education project. The project aimed at improving the reproductive health status of teenagers in an environment of widespread teenage pregnancy and childbearing. High level of sexual activity is evident among Nembe teenagers, as revealed by the level of sexually experience, coital frequency and sexual networking. Consequently, the levels of teenage pregnancy, childbearing, induced abortion and infection with sexually transmitted diseases are high. High levels of sexual activity are in part related to widespread poverty occasioned by environmental degradation resulting from oil exploration in the area, which has virtually destroyed fishing as the main occupation, both of men and women. The study found that the most serious problems confronting Nembe youth are inadequate education and lack of employment; teenage girls are therefore attracted to the migrant oil-men and others who could provide their material needs, a luxury for their poverty-stricken parent. Intervention programmes suggested to improve teenage reproductive health status include provision of vocational training, initiation of family-life education and counselling for in-school and out-of-school youth, improvement of the environment and improved parental responsibility for their children. Following from the results of this study, the IFLE project has been pre-occupied with school and community-based participatory intervention programmes in two Nembe communities in the past three years. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 177149.Article de périodique
Adewole I.F.; Oye Adeniran B.A.; Iwere N.; Oladokun A.; Gbadegesin A.
Terminating an unwanted pregnancy-the economic implications in Nigeria
2002 - J Obstet Gynaecol, 22(4), p. 436-437
Mots clés : avortement; facteur économique; législation; âge; service de santé; complication; grossesse non prévue; grossesse non désirée; enquête
Pays / Régions : NigeriaRésumé : Induced abortion is still illegal in Nigeria and carries a stiff penalty of 14 years imprisonment for the abortion provider (Okagbue, 1990). Despite this, termination of an unwanted pregnancy is being carried out daily both by trained and untrained personnel, albeit with the utmost secrecy; except when it becomes complicated (Okagbue, 1990; Henshaw et al., 1998). The national survey indicated that about 610 000 pregnancy terminations occur in Nigeria yearly, and about 141 000 patients were treated for complications of pregnancy termination (Henshaw et al., 1998). Because of the unfavourable legal environment, patients with unwanted pregnancies could not turn legally to a government hospital, where personnel and facilities exist for an adequate and safe procedure. The majority of induced abortion seekers end up with 'quacks' at a very high risk to their health, as frequently these become complicated. The threats to a woman's health from unsafe abortion are considerable. It has been proven that this termination of unwanted pregnancy when performed by trained medical personnel could be safe. This has been shown in countries where abortion is legalised, many of which are now publishing low morbidity and morality figures following induced abortion. Despite the controversies surrounding termination of unwanted pregnancies, many medical doctors, specialists and non-specialists as well as non-medical personnel still provide services for pregnancy termination (Megafu and Ozumba, 1991; Adewole, 1992). In Nigeria, the situation is still gloomy. Complications of induced abortion are being treated daily in our health institutions. Several efforts have been made to quantify the financial cost of treating these complication based on the type of complication (Konje et al., 1992), the need for surgical and/or medical care, the need for blood transfusion and hospitalisation. What is the cost of pregnancy termination to the patient? (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 184921.Article de périodique
Cook C.T.
The effects of skilled health attendants on reducing maternal deaths in developing countries: testing the medical model
2002 - Evaluation and Program Planning, 25(2), p. 107-116
Source : source : Evaluation and Program Planning.Article de périodique
Chikovore J.; Lindmark G.; Nystrom L.; Mbizvo M.T.; Ahlberg B.M.
The hide-and-seek game: men's perspectives on abortion and contraceptive use within marriage in a rural community in Zimbabwe
2002 - Journal of Biosocial Science, 34(3), p. 317-332
Mots clés : méthodologie; enquête; rural; résidence; homme; contraception; méthode contraceptive; perception; mariage; état matrimonial; collecte; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement; nuptialité; état matrimonial; mariage
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This paper is based on a study aimed at understanding the perceptions of men to induced abortion and contraceptive use within marriage in rural Zimbabwe. Two qualitative methods were combined. Men were found to view abortion not as a reproductive health problem for women. Instead, they described abortion as a sign of illicit sexual activity and contraceptive use as a strategy married women use to conceal their involvement in extramarital sexual activity. Men felt anxious and vulnerable for lack of control over women. In the absence of verbal communication on sexual matters, women and men resort to what are called here 'hide-and-seek' strategies, where women acquire and use contraceptives secretly while men search for evidence of such use. It is concluded that promoting women's sexual and reproductive health requires both short- and long-term strategies. The short-term strategy would entail providing women with reproductive technology they can use without risking violence. The long-term strategy would entail understanding men's concerns and the way these are manifested. In turn this requires the use of methodologies that encourage dialogue with research participants, in order to capture their deep meanings and experiences. (© 2002 Cambridge University Press)
Source : source : journal of biosocial science http://titles.cambridge.org/journals/journal_catalogue.asp?historylinks=ALPHAmnemonic=JBS.Article de périodique
Johnson Hanks J.
The lesser shame: abortion among educated women in southern Cameroon
2002 - Social Science and Medicine, 55(8), p. 1337-1349
Mots clés : enquête; avortement; attitude; enquête démographique et de santé; EDS; santé de la reproduction; méthodologie; mariage; femme; comportement; collecte; facteur démographique; planning familial; contraception d'urgence; contraception postcoitale; santé; état matrimonial; nuptialité; état matrimonial; mariage; population; psychologie; facteur psychologique
Pays / Régions : Cameroun; Afrique; Afrique Subsaharienne; Afrique Francophone; Afrique CentraleRésumé : Educated women in southern Cameroon both condemn abortion and practice it with some regularity. This apparent paradox arises because educated Cameroonian women use abortion as one of a set of strategies to manage the timing and social context of entry into motherhood. This paper is based on a body of research which included a demographic life history survey (= 184), open-ended narrative interviews (= 37), and participant observation over 10 months. The survey data included 61 reported abortions, giving a lower-bound estimate of the crude abortion rate of 19 per thousand woman-years of life. In southern Cameroon, sexual activity is socially tolerated in a wide variety of non-marital relationships, while childbearing is not. Thus, most of my informants, including those who reported having aborted, say that abortion is shameful; however, they view its moral and social consequences as less grave than those of a severely mistimed entry into socially recognized motherhood. That is, abortion persists in southern Cameroon because it is the lesser shame. (author's)
Source : Source : Social Science Medicine.Congrès
Guengant J. P.
The proximate determinants during fertility transition
2002 - Expert group meeting on completing, the fertility transition, New York, 22 p.
Mots clés : fécondité
Source : source : Ceped.Article de périodique
Garenne M.; Joseph V.
The Timing of the Fertility Transition in Sub-Saharan Africa
2002 - World Development, 30(10), p. 1835-1843
Mots clés : méthodologie; enquête; enquête démographique et de santé; EDS; fécondité; ville; résidence; rural; résidence; étudiant; scolarisation; population; facteur démographique; facteur géographique
Pays / Régions : Afrique Subsaharienne; Kenya; Afrique; Afrique Anglophone; Afrique de l'EstRésumé : If demographic and health surveys have underlined declining fertility trends in many countries of sub-Saharan Africa, little is known on the precise timing and the speed of the fertility transition in the continent. This study attempts to fill this gap, by using an innovative approach to the analysis of Demographic and Health Survey data and other relevant surveys. The method utilizes fine tuning of fertility trends year by year, for urban and rural areas separately. The paper starts by a case study of the fertility transition in Kenya. The same method is later applied to more than 20 countries. Results indicate that in many countries, fertility started to decline in the late 1960s and 1970s in urban areas, and about 10 years later in rural areas, much earlier than usually thought. Placing a time frame at the onset of the fertility transition allows one to develop further analysis of the key determinants of the fertility transition. Emphasis is on the role of family planning programs, as well as on emerging independent individual behavior such as delayed marriage and induced abortions. Comparison is made with the situations of other developing countries, and with the possible role of mass media, in particular television. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 171358.Article de périodique
Ahman E.; Shah I.H.
Unsafe Abortion: Worldwide Estimates for 2000
2002 - Reproductive Health Matters, 10(19), p. 13-17
Mots clés : avortement à risque; contraception; méthode contraceptive; méthodologieRésumé : Unsafe abortion is preventable and yet remains a significant cause of maternal morbidity and mortality in much of the developing world. Over the last decade, the World Health Organization has developed a systematic approach to estimate the regional and global incidence of unsafe abortion. Estimates based on figures around the year 2000 indicate that 19 million unsafe abortions take place each year, that is, approximately one in ten pregnancies ended in an unsafe abortion, giving a ratio of one unsafe abortion to about seven live births. Almost all unsafe abortions take place in the developing world. In Latin America and the Caribbean, 3.7 million unsafe abortions are estimated to take place each year, with an abortion rate of 26 per 1000 women of reproductive age, almost one unsafe abortion to every three live births. Asia has the lowest unsafe abortion rate at 11 per 1000 women of reproductive age, but 10.5 million unsafe abortions take place there each year, almost one unsafe abortion to every seven live births. However, excluding East Asia, where most abortions are safe and accessible, the ratio for the rest of Asia is one unsafe abortion to five live births. In Africa, 4.2 million abortions are estimated to take place per year, with an unsafe abortion rate of 22 per 1000 women, or one unsafe abortion per seven live births. In contrast, there is one unsafe abortion per 25 live births in developed countries.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Raufu A.
Unsafe abortions cause 20 000 deaths a year in Nigeria
2002 - Bmj, 325(7371), p. 988
Mots clés : avortement; mortalité; femme; homme; mortalité maternelle; épidémiologie; grossesse
Pays / Régions : Nigeria
Source : source : BMJ.Article de périodique
Teklehaimanot K.I.
Using the Right to Life to Confront Unsafe Abortion in Africa
2002 - Reproductive Health Matters, 10(19), p. 143-150
Mots clés : avortement à risque; droit; croyance; plaidoyer
Pays / Régions : AfriqueRésumé : Unsafe abortion is one of the leading causes of maternal mortality in Africa. In international human rights law, there are two possible approaches to tackling the problem of unsafe abortion. One is to advocate the right of privacy, which means states must refrain from interfering in women's abortion decisions; the other is to advocate the right to life of women, which stresses the duty of states to take affirmative measures to minimise the consequences of unsafe abortion. African societies are communal and duty is the central element in them. The African Charter on Human and Peoples' Rights reflects communal values by stressing the duty of individuals to help their communities. Unlike other human rights documents, it does not have a right of privacy provision. This paper focuses mainly on the right to life and discusses the interpretation of this right for women, as applied to unsafe abortion, under the International Covenant on Civil and Political Rights. Advocating states' duties in ensuring women's right to life, to minimise the consequences of unsafe abortion, is more consistent with duty-based African communal values than the right of privacy.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Granja A.C.; Zacarias E.; Bergstrom S.
Violent deaths: the hidden face of maternal mortality
2002 - Bjog, 109(1), p. 5-8
Mots clés : méthodologie; enquête; grossesse; mortalité maternelle; suicide; violence; étudiant; scolarisation; population; facteur démographique; mortalité
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : This study aims to review pregnancy-related deaths due to injuries, to identify the characteristics of these women and to compare the magnitude of injury- related maternal deaths to that of other causes of maternal death. It is a retrospective study performed during a 5-year period (1991-95), covering deaths from injuries, including suicide, homicide and accidents in Maputo, Mozambique. Its target population is the pregnant or recently pregnant (post-abortion and postpartum) population of Maputo City, the national capital of Mozambique. 27 cases of pregnancy-related deaths caused by injuries were identified. The proportion of deaths due to homicide, suicide, and accidents in pregnant women or within 42 days after termination of pregnancy, were the main outcome measures. 10 cases were due to alleged homicide, nine to alleged suicide and six to alleged accident. 59% (16/27) of women suffering an injury-related maternal death were younger than 25 years of age. 85% of pregnancies were <28 weeks of gestational age. The magnitude of the problem of violence-related maternal deaths compares with the magnitude of pregnancy-induced hypertension as the fourth cause of maternal death at Maputo Central Hospital. The contribution of violence-related deaths to maternal mortality is significant and must not be neglected. (author's, modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 164553.Rapport
United Nations; Population Division
World population monitoring 2002. Reproductive rights and reproductive health: selected aspects
2002 - United Nations, New York, 191
Mots clés : facteur démographique; politique; méthodologie; population; évaluation
Source : Source : Ceped.Article de périodique
Mashamba A.; Robson E.
Youth reproductive health services in Bulawayo, Zimbabwe
2002 - Health Place, 8(4), p. 273-283
Mots clés : enquête; focus group; enquête; analyse; jeune; adolescent; grossesse adolescente; grossesse; service de santé; santé de la reproduction; programme; étudiant; scolarisation; méthodologie; collecte; âge; population; facteur démographique; fécondité; soin; santé; psychologie; facteur psychologique; comportement
Pays / Régions : Zimbabwe; Afrique Anglophone; Afrique; Afrique de l'Est; Afrique SubsaharienneRésumé : This study examines young people's access to reproductive healthcare services via an urban youth advisory centre in Bulawayo, Zimbabwe. The aim is to explain why teenagers do not always use existing health services. Data from exit questionnaires with users and focus groups with non-users are analysed to evaluate service accessibility. Analysis suggests that even where clinics are spatially accessible, barriers to access include temporal factors, lack of factual knowledge and stigmatisation. The paper concludes that spatial accessibility is not the only factor necessary to ensure equal access to health services. Recommendations are made towards tackling young people's unmet needs for reproductive healthcare services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 178935.
2000Article de périodique
Rutgers S.
Abortion admissions in rural Matebeleland north province
2001 - Cent Afr J Med, 47(9-10), p. 214-220
Mots clés : avortement; mortalité
Pays / Régions : ZimbabweRésumé : The study describes the characteristics, clinical features and management of women admitted with an abortion in rural Zimbabwe. in four government and two mission hospitals in rural Matebeleland North province. The Hospital records of 355 consecutive women admitted with the diagnosis abortion from May to October 2000, and delivery registers covering the same six month period were analysed . Abortion patients tended to be older and of higher parity than women who delivered in the same period. Fifteen percent were teenagers, 81.2% were married and 2% nullipara. Mean period of gestation was 11.3 weeks. About half of the women had been referred and 74.4% lived within a 50 km radius from the hospital. Forty two percent had never used contraception. Of the users, 38.6% had discontinued in order to conceive and 19.3% had fallen pregnant on the method. Thirty one percent of the women wanted no more children. One third of the abortion patients had a temperature above 37.6 degrees C; 25.9% offensive vaginal discharge and 7% a haemoglobin of less than 6 g/dl. Eighty percent were given antibiotics and 4.2% received a blood transfusion; 73.2% had an evacuation of the uterus for incomplete abortion, with a mean delay between admission and evacuation of 32.5 hours. Only 17.5% of the women had on record that they were given a contraceptive method on discharge. Mean length of hospital stay was 3.1 days. The case fatality rate was more than 1%. An estimated 43.4% of the women had a possibly unsafe induced abortion prior to admission. CONCLUSION: As evidenced by the high morbidity and mortality, abortions are a serious public health problem in rural Matebeleland North. Taking into account that only a minority of the women with both unsafe and spontaneous abortions present to a hospital, it is imperative that the reproductive needs of the women who do come are addressed. No opportunity should be missed to offer contraceptives to a group of women whose use of contraception is lower than average. Clinical management of abortion patients could improve by earlier evacuation of the uterus in cases of incomplete abortion, use of local or no anaesthesia and by increased availability of suction cannulas in district level hospitals, which would also reduce length of hospital stay.
Source : source : Central African Journal of Medicine.Article de périodique
Yusuf L.; Zein Z.A.
Abortion at Gondar College Hospital, Ethiopia
2001 - East African Medical Journal, 78(5), p. 265-268
Mots clés : méthodologie; mariage; femme; taux; complication; état matrimonial; nuptialité; état matrimonial; mariage; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ethiopie; Afrique Subsaharienne; AfriqueRésumé : This descriptive cross-sectional situational study reviewed the pattern and magnitude of abortion to establish baseline facts and data for future studies. Analysis of the clinical picture of abortion was conducted at the Gondar College of Medical Sciences Hospital among 1191 patients, mostly married housewives originating from Gondar. The abortion rate and the ratio per 100 pregnancies and deliveries were 11.5 and 16.4, respectively. Patients who admitted to a history of interference with pregnancy were only 13.4%, in which cases data were obtained from 10.6%. The mean gestational ages for septic and nonseptic cases were 14.6 and 15.2 weeks, respectively, even though pregnancies of <12 weeks from the last normal menstrual period accounted for 50.5%. The commonly diagnosed clinical type was incomplete abortion, followed by inevitable and threatened abortion. The vast majority of the clinical conditions were nonseptic (85.1%) and spontaneous (85.6%), while the most common complications were anemia, genital tract infection, shock of various causes, and soft tissue injury.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 159080.Article de périodique
Aberra Y.
Abortion in Ethiopia letter
2001 - Africa Health, 23(3), p. 2
Mots clés : loi; politique; programme; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : As I am a General Practitioner working in a rural part of the country, I cannot get even Gutenburg's typewriter (and forget a Personal Computer!), but I have managed to write to you anyway--by hand! Ethiopia is one of the poorest countries in the world, with a population of 60 million. The fertility rate per woman is 7.7 children, and the maternal mortality rate is 500-600 per 100,000 live births. Primary health care facilities are still very meager, and health education is rare. Worse is the situation when we come to the delivery of sex education and family planning services. Unwanted pregnancy is common, and abortion is illegal. Even though abortion is not a good method of family planning, we must choose the lesser evil: to do legal, safe abortions, or to continue watching the bitter consequences of unwanted pregnancy. Abortion is of course an issue of religion, morality, and attitude. But there are already some nongovernmental organization health institutions which do safe abortions in big towns in Ethiopia under cover of names like "menstrual regulation". But a good number of females, especially in their teens, go to the back-street abortionists, who operate unsafely. So should we legalize safe abortion in Ethiopia in the hands of the skilled and help these unfortunate females, or should we sit indifferently and keep on watching our teen sisters die of sepsis and bleeding due to unsafe abortions? (full text)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156972.Ouvrage
United Nations; Population Division
Abortion Policies. A global review - vol I Afghanistan to France
2001 - New York: United Nations, 183 p.Résumé : The country reports of national policies concerning induced abortion presented in Volume I of "Abortion Policies: A Global Review", covers abortion policies from Afghanistan to France. This document aims to provide objective information on the nature of abortion laws and policies at the end of the 20th century which include information on the social and political settings, ways in which they have been formulated, and their evolution over time. Chapter 1 presents major dimensions of abortion policies with a discussion on challenges in the practical and conceptual context, as well as on the conformity of written law or policies with practices. Chapter 2 outlines the description of the variables identified in each country profile, namely: grounds on which abortion is permitted; reproductive health indicator, and abortion policies and their national context. The third chapter details country profiles, which are arranged alphabetically.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 162030.Ouvrage
United Nations; Population Division
Abortion Policies. A global review - vol II Gabon to Norway
2001 - New York: United Nations, 209 p.Résumé : This is the second of three planned volumes presenting a country-by-country examination of national policies concerning abortion. Information in this volume is provided in alphabetical order from Gabon to Norway, and concerns each country's abortion policy, the fertility and mortality context in which abortion policy has been developed, and statistics on induced abortion. (ANNOTATION)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 129976.Article de périodique
Jali M.N.
Abortion--a philosophical perspective
2001 - Curationis, 24(4), p. 25-31
Mots clés : avortement; éthique; grossesse
Pays / Régions : Afrique du Sud
Source : source :Curationis.Article de périodique
Silberschmidt M.; Rasch V.
Adolescent girls, illegal abortions and "sugar-daddies" in Dar es Salaam: vulnerable victims and active social agents
2001 - Social Science and Medicine, 52(12), p. 1815-1826
Mots clés : méthodologie; adolescence; adolescent; loi; risque; sexualité; contraception; méthode contraceptive; homme; jeune; adolescent; âge; population; facteur démographique; avortement; contraception d'urgence; contraception postcoitale; planning familial; comportement; psychologie; facteur psychologique
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Adolescent girls' early sexual activity, early pregnancy, induced abortions and the increase in HIV infections have become major concerns in sub-Saharan Africa. Efforts, though, to understand their sexual behavior and to prevent reproductive health problems are almost non-existent. Adolescent girls are normally seen as victims and easy prey of (often older and married) men's sexual exploitation. This article, which is based on a qualitative study of 51 adolescent girls who had just had an illegal abortion in Dar es Salaam, Tanzania, reveals that these girls are not only victims but also willing prey and active social agents engaging in high-risk sexual behavior. In order to get material benefits they expose themselves to serious health risks, including induced abortion -- without realizing their own vulnerability. In the author's study, one out of four girls had more than one partner at the time they became pregnant, and many counted on an illegally induced abortion if they got pregnant. Even if adolescents are now allowed free access to family planning information, education and services, the authors' study shows that this remains in the realm of theory rather than practice. Moreover, most adolescent girls are not aware about their right to such services. The paper concludes that the vulnerability of adolescent girls increases without the recognition that sexuality education and contraceptive services do not constitute a license to practice illicit sex -- but rather a means to create more mature and responsible attitudes and to increase sexual and reproductive health. (author's)
Source : Source : Social Science Medicine.Article de périodique
Granja A.C.; Machungo F.; Gomes A.; Bergstrom S.
Adolescent maternal mortality in Mozambique
2001 - Journal of Adolescent Health, 28(4), p. 303-306
Mots clés : méthodologie; adolescence; adolescent; mortalité maternelle; décès; grossesse; paludisme; maladie; Hypertension; HTA; taux; jeune; adolescent; âge; population; facteur démographique; mortalité; maladie; complication; maladie; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : This study aimed to demonstrate the adolescent maternal mortality in Maputo Central Hospital (HCM) by using an audit approach and by analyzing the avoidability of maternal deaths in adolescents. A total of 239 maternal deaths were analyzed according to circumstances of death, antenatal care, and care in other health centers and in the HCM. Analysis was carried out to detect any avoidable factor attributable to the patient, to the care provided at peripheral units, or to the care provided at HCM. Overall, results show a 30% higher institutional maternal mortality ratio in adolescents than in non-adolescents. Similar results regarding higher obstetric risk of death in adolescents were found in other institutional and community-based maternal mortality studies. The main causes of adolescent deaths include malaria, pregnancy-induced hypertension, puerperal sepsis, and septic abortion. The audit classified 75% of all maternal deaths as avoidable. To this effect, adequate strategies addressing the special needs of adolescents are required to prevent high levels of maternal mortality in this age group.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156194.Article de périodique
Dickson Tetteh K.
Adolescent reproductive health in Africa: a problem or a priority? editorial
2001 - African Journal of Reproductive Health / Revue Africaine de la Sante, 5(3), p. 11-12
Mots clés : adolescence; adolescent; santé de la reproduction; programme; VIH; sida; avortement; genre; jeune; adolescent; âge; population; facteur démographique; santé; maladie; maladie; complication; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : Adolescents are generally thought to be healthy, yet many of them die prematurely. The four major causes of death among them are road traffic accidents, suicide, tobacco use, and sexual and reproductive disorders. Focusing on adolescent reproductive health, it is noted that in many African countries, HIV prevalence levels are high among young people. It is projected that half of the 15-year-olds in South Africa and Zimbabwe will eventually die of AIDS, as will least one-third of this population in another 16 sub-Saharan countries where HIV prevalence is 10% or higher. Levels of unintended pregnancies among teenagers are also high, with more than one-fifth of recent births reported as unintended. Moreover, up to 4.4 million women aged 15-19 years undergo unsafe abortions annually, most often carried out illicitly by unqualified practitioners, and which result in complications. However, a substantial number of young people have indicated that they need information on matters such as pregnancy, sexually transmitted infections, sexual intercourse and relationships. To this effect, the WHO and its partners advocate a comprehensive approach to enable adolescents to develop their full potential to be healthy. The common agenda advocates creating a safe and supportive environment, providing information and rebuilding skills, and expanding access to health services. Special efforts should be made to develop gender sensitive programs.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 165900.Article de périodique
Alubo O.
Adolescent reproductive health practices in Nigeria
2001 - African Journal of Reproductive Health, 5(3), p. 109-119
Mots clés : méthodologie; enquête; focus group; enquête; adolescence; adolescent; étudiant; scolarisation; santé de la reproduction; service de santé; genre; collecte; jeune; adolescent; âge; population; facteur démographique; éducation; santé; soin; culture
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Adolescents have become a focal point of discussions of sexuality and reproductive health (RH) matters because they belong to a most active segment of the population and because of practical concerns in resolving problems such as unintended pregnancy and sexually transmitted diseases (STDs), including HIV/AIDS. Employing in-depth interviews and focus group discussion techniques, this study of 2510 respondents from four tertiary educational institutions in Nigeria examined various forms of RH practices, their origins, RH services available in the institutions, and the role of gender relations in RH concerns. The findings show that respondents engage in a wide range of folk practices and do-it-yourself procedures to maintain personal hygiene, prevent and treat STDs, as well as prevent and terminate unwanted pregnancies. These practices, which involve the use of every day commodities such as lime, antacid, and other drugs in particular ways, are learned from and passed on through peers. The practices are considered more confidential and are preferred to the RH services in the institutions' clinics. There are obvious implications for avoidable complications, morbidity and mortality, all of which need to be redressed through intervention. (author's) .
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 165910.Congrès
Ngondo a Pitshandenge S.
Amitiés, sexualité et avortement en milieu scolaire. Le cas de la ville de kikwit (République Démocratique du Congo)
2001 - Les transitions démographiques des pays du SudJournées Scientifiques du Réseau Démographique de l'Agence Universitaire de la Francophonie, 3, Rabat (MA) 1999/12/9-12, Paris (FR), Estem, p. 241-250 p.
Mots clés : adolescence; adolescentRésumé : Les comportements adoptés par les jeunes en matière de nuptialité, de sexualité et d'avortement au cours d'une époque peuvent augurer des changements dans le domaine de la croissance démographique. A défaut d'un déclin de la mortalité, en effet, ces comportements peuvent conduire, pour leur impact sur la fécondité à une transition démographique provoquées uniquement par le déclin de la fécondité. C'est cette présomption que nous voulons défendre à travers cette propension aux amitiés et aux fiançailles, la forte intensité de la sexualité et le recours à l'avortement que nous avons noté lors d'une étude en milieux scolaires dans la ville de Kikwit. L'étude a porté sur un échantillon probabiliste de 802 filles scolarisées, prélevé dans 25 classes de 5ème et 6ème des Humanités de 13 écoles de la place; Ces classes n'ont renfermé que les filles célibataires, âgées de 15 - 21 ans. A l'analyse, il est ressorti que 635 de ces étudiantes, soit 79% de l'ensemble étaient impliquées dans les liens des fiançailles ou de "copinage". Pour des raisons aussi bien affectives qu'économiques, quelques-unes de ces étudiantes vivaient en "relations polyandriques" cumulant fiancé et copain. Sous couvert de ces relations, les étudiantes fiancées ou ayant un copain surtout menaient une vie sexuelle relativement intense.Calculs faits, les avortements provoqués enregistrés ces les étudiantes sous étude, conséquences d'une sexualité non protégée, parviennent à réguler une fécondité des jeunes scolarisées dont le niveau est égal à celui de filles de leur âge régulièrement mariées et gardant leur grossesse (Résumé d'auteur)
Source : Source Ceped : http://ceped.cirad.fr.Chapitre d'ouvrage
Barrère M.
Avortement
2001 - In F. DGSEE, ORC Macro (Ed.) Enquête Démographique et de santé Gabon 2000, p. 86-98. Calverton, Maryland, USA:
Pays / Régions : Gabon
Source : Source Ceped : http://ceped.cirad.fr.Chapitre d'ouvrage
Unité de Recherche Démographique URD (Université du Bénin); Direction Générale de la Statistique; de la Comptabilité Nationale
Avortement au Togo
2001 - Famille, migration et urbanisation au Togo. Résultats de l'enquête quantitative., p. 13. Lomé, Togo: URDDGSCN
Pays / Régions : Togo
Source : source : Ceped http://ceped.cirad.fr.Article de périodique
Ramonate N.; Hiemstra L.A.; de Coning E.C.; Nel M.
Bio-social profile and survey of women seeking termination of pregnancy at Pelonomi and national hospitals, Bloemfontein
2001 - S Afr Med J, 91(6), p. 500
Pays / Régions : Afrique du Sud
Source : source S Afr Med J.Article de périodique
Elul B.; Hajri S.; Nguyen thi Nhu N.; Ellerston C.; Ben Slama C.; Pearlman E.; Winikoff B.
Can women in less-developed countries use a simplified medical abortion regimen?
2001 - Lancet, 357(9266), p. 1402-1405Résumé : Mifepristone-misoprostol abortion, consisting of oral pills, is potentially simple and safe enough for use in less-developed countries. But the labor-intensive, costly, clinic-based European protocols are not affordable or feasible in most less-developed countries. The authors prospectively tested two simplifications to the French mifepristone-misoprostol regimen in Vietnam and Tunisia. Women (n = 315) with amenorrhea of 8 weeks or less since their last menstrual period received 200 mg mifepristone in the clinic and then chose whether to take 400 mcg oral misoprostol 2 days later either at home or in the clinic. Despite a two-thirds reduction in the mifepristone dose, success rates were high: Vietnam 93%, Tunisia 91%. About 88% of participants chose home administration of misoprostol. Most Vietnamese and Tunisian women were satisfied with their abortions, but efficacy and satisfaction rates were higher among those who used misoprostol at home. A simplified medical abortion regimen of 200 mg mifepristone, followed by the option of home administration of misoprostol, seems feasible. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 157201.Article de périodique
Fekadu Z.
Casual sex-debuts among female adolescents in Addis Ababa, Ethiopia.
2001 - Ethiopian Journal of Health Development., 15(2), p. 109-116.
Mots clés : méthodologie; enquête; adolescence; adolescent; sexualité; femme; étudiant; scolarisation; jeune; adolescent; âge; population; facteur démographique; psychologie; facteur psychologique; comportement
Pays / Régions : Ethiopie; Afrique Subsaharienne; AfriqueRésumé : Abstract: In the era of the HIV/AIDS epidemic, understanding the nature of sexual debut among female adolescents is critical in developing effective preventive strategies. The objectives of the study were to investigate the specific age at sexual debut, to identify the specific reasons for sexual debut, and to examine the self- restraining capability of female adolescents. A self-administered questionnaire survey was conducted among sexually active adolescent females in Addis Ababa. A total of 354 sexually active female adolescents (aged 15-19 years) completed the self- administered questionnaire, of which 29% had planned sex, while the remaining 71% reportedly had casual sex. Moreover, 22% reported ever use of condoms, while 24% admittedly had experienced abortion. With the average age at sex debut being 16.7 years (standard deviation = 1.7), the respondents initiated sex as early as 11 years. Some of the reasons for sexual debut were identified, with 'maintaining relation with male partner' (51%), 'for the sake of passionate love' (45.8%), and 'to overcome loneliness' (40%) being the three most important reasons given. Regarding self-restraining capacity, the majority of the respondents (75.4%) indicated that they had 'little or no control over' their sexuality in the face of sexual advances made by male partners. Efforts must be strengthened to empower young female adolescents to protect themselves from sexual exploitation. (author's, modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 161929.Article de périodique
Strickler j.; Heimburger A.; Rodriguez K.
Clandestine abortion in Latin America: a clinic profile
2001 - International Family Planning Perspectives, 27(1), p. 34-36
Pays / Régions : Amérique LatineRésumé : Context: Most research on abortion in Latin America has focused on women who are hospitalized with abortion complications, but little is known about the characteristics of women who are able to obtain clandestine procedures performed by trained personnel working in sanitary conditions. Methods: Analysis of medical records for 808 clients of an urban clandestine abortion service in South America was supplemented with observation of clinic operations for six weeks in 1995. Results: Nearly nine in 10 clients had at least a secondary education, about three-quarters were younger than 30 and a similar proportion were unmarried. Fifty-four percent had never given birth, and 13% had had at least one prior abortion. Three-fifths of women had not been using a contraceptive method when they conceived; among users, three-fifths had been using a traditional method. Three percent experienced mild complications related to the procedure (e.g., heavy bleeding or pelvic pain), and another 2% reported serious complications (e.g., pelvic infection, hemorrhage or suspected uterine perforation). Conclusions: To reduce the need for abortion, it is important for family planning programs to include women who are young, unmarried and highly educated in their outreach efforts.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2703401.html.Article de périodique
Goyaux N.; Alihonou E.; Diadhiou F.; Leke R.; Thonneau P.F.
Complications of induced abortion and miscarriage in three African countries: a hospital-based study among WHO collaborating centers
2001 - Acta Obstetricia et Gynecologica Scandinavica, 80(6), p. 568-573
Mots clés : méthodologie; issue grossesse; complication; avortement spontané; risque; grossesse; santé de la reproduction; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication
Pays / Régions : Bénin; Cameroun; Sénégal; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique Francophone; Afrique CentraleRésumé : The aim of this study was to describe two of the outcomes of pregnancy, induced abortion and miscarriage, in three African countries. Major maternal risk factors were also evaluated. The study was prospective and based on the medical files of all 1957 women admitted to participating health care structures. Overall, 988 women were admitted for complications of miscarriage, and 969 for complications of induced abortion. Gestational age was lower in women with miscarriages (p < 0.002). The level of use of contraceptive methods (p < 0.003) and educational level (p < 0.005) were lower in women who had had an induced abortion. In the authors' study, 26 maternal deaths were recorded, 22 of which were associated with induced abortion. Infection was the most important risk factor for death (odds ratio = 4.8; 1.9-12.4). Maternal deaths related to abortion complications often occurred shortly after hospital admission and with signs of sepsis. This demonstrates the importance of effective emergency services. Unfortunately, hospital-based studies alone cannot assess all maternal death risk factors, especially those for maternal death related to induced abortion complications. It is therefore important to determine what happened to the woman before hospital admission and during her stay in hospital. Combinations of qualitative and quantitative methods could be used to increase the authors' understanding of this problem and to help them solve it. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 163141.Article de périodique
Dakun J.T.
Consequences of adolescents sexual behaviour
2001 - Grassroots Health News, 2(2), p. 5
Mots clés : adolescence; adolescent; sexualité; risque; santé; complication; jeune; adolescent; âge; population; facteur démographique; psychologie; facteur psychologique; comportement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Nigeria; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The consequences of misguided adolescent sexuality have been summarized by the Ghana Social Marketing Foundation into two main risks: health and social risks. The health risks include early or unwanted pregnancy, unsafe abortion, sexually transmitted diseases (STDs) and HIV/AIDS infections, while social risk includes school drop out, leading to social, economic, and intellectual underdevelopment for the individual, and health and manpower crisis for the nation. In Nigeria, many teenage girls who get pregnant often resort to criminal unsafe abortion. In the northern part of Nigeria, a study conducted on attitudes to abortion revealed that 58% of the abortion patients admitted having unsuccessfully tried to induce abortion. It is noted that lack of information on STDs/HIV also exposes Nigerian youth to STDs/HIV/AIDS infection. A study in Plateau and Bauchi States reveals that knowledge about the prevalence of disease that are transmitted sexually is high among the youth, but knowledge of specific STDs, of prevention is low and vary according to ages and location.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 166068.Congrès
Guillaume A.
Contraception et avortement: deux modes de régulation de la fécondité à Abidjan (Côte d'Ivoire)
2001 - ¨XXIV IUSSP General Conference, Salvador Brazil, 11 p. p.
Mots clés : fécondité
Pays / Régions : Cote d'IvoireRésumé : En Côte d'ivoire, comme dans de nombreux pays d'Afrique de l'Ouest, l'avortement est illégal. Il représente une cause majeure de morbidité et de mortalité maternelles, car est pratiqué le plus souvent dans des conditions d'hygiène et de sécurité insuffisantes. Les données sur ce sujet sont rares, et émanent principalement d'enquêtes menées dans des structures hospitalières où les femmes se rendent pour des complications. Cependant quelques études récentes ont montré l'importance de cette pratique et sa croissance rapide ces dernières années : l'avortement intervient parfois comme mode de régulation de la fécondité et influe sur son niveau.Les résultats présentés ici sont issus d'enquêtes menées auprès de consultants (hommes et femmes) dans des centres de santé de la ville d'Abidjan. Le choix de travailler auprès de consultants se justifie car - d'une part cette étude s'inscrivait dans le cadre d'un programme de recherche appliquée sur la planification familiale mené dans des structures sanitaires - et d'autre part car cet acte étant illégal, une étude approfondie en population générale, sur la pratique de l'avortement était difficile. Une enquête quantitative a été menée sur une population de 2400 femmes et 600 hommes venus en consultation. Le questionnaire de l'enquête qualitative comprenait un module sur la vie génésique complète des femmes, les connaissances et pratiques de la contraception et un module spécifique sur l'avortement : méthodes connues et utilisées, raisons de l'avortement, pratique de la contraception avant et après cet avortement, processus de décision et coût du recours à l'avortement, connaissance et opinion par rapport à la légalisation de l'avortement. Des entretiens ont été menés auprès de consultants et de personnels de santé.Les données ont été analysées à l'aide de méthodes bivariées et multivariées (régressions logistiques) pour déterminer les relations entre les caractéristiques socio-démographiques des femmes, la pratique de la contraception et le recours à l'avortement.Bien qu'illégal en Côte d'Ivoire, le recours à l'avortement provoqué est très fréquent à Abidjan et cette pratique est souvent " à répétition ". Les femmes recourent à l'avortement pour éviter des grossesses non désirées et ce recours s'est accentué récemment. L'avortement est utilisé comme " méthode de planification familiale " par des femmes qui veulent réguler leur fécondité en limitant leur descendance ou en espaçant leurs naissances, mais qui n'utilisent pas la contraception pour différentes raisons : soit elles n'ont pas accès aux services de planification familiale, soit elles ont une mauvaise opinion de ces méthodes ou elles ont déjà connu un échec avec ces méthodes. Malgré une bonne connaissance de la contraception, son utilisation reste modérée particulièrement pour les méthodes modernes et certaines femmes ont eu des grossesses non désirées qui se sont terminées par un avortement provoqué alors qu'elles utilisaient une méthode naturelle de contraception.Des contraintes familiales, sociales ou économiques expliquent ce recours à l'avortement : il est particulièrement fréquent chez les jeunes femmes, non mariées, qui craignent à cause de cette grossesse un rejet social ou familial ou un abandon précoce de leur scolarité.L'avortement a un impact non négligeable sur la fécondité puisqu'il explique une partie de la diminution du niveau enregistré ces dernières années, en l'absence d'une pratique généralisée de la planification familiale.Bien que pratiqué majoritairement par des méthodes chirurgicales, l'avortement est fait le plus souvent pas du personnel médical non qualifié et expose les femmes à des problèmes de santé, d'autant plus que la prise en charge post-abortum est quasiment inexistante. L'avortement pose ainsi un large problème de santé publique.
Source : source : http://www.iussp.org/Brazil2001/s20/S21_P08_Guillaume.pdf.Article de périodique
Joseph V.; Garenne M.
Dating of fertility decline in sub-Saharan AfricaDatation de la baisse de la fecondite en Afrique subsaharienne
2001
Mots clés : méthodologie; transition fécondité; déterminant fécondité; programme planning familial; avortement; mariage; état matrimonial; fécondité; population; facteur démographique; programme; planning familial; contraception d'urgence; contraception postcoitale; nuptialité; état matrimonial; mariage
Pays / Régions : Kenya; Afrique Subsaharienne; Afrique de l'Est; Afrique; Afrique AnglophoneRésumé : The authors present the results of a study conducted to determine when fertility began to decline in sub-Saharan Africa. Such declines lay at the core of demographic transition processes in developing countries. While Demographic and Health Surveys (DHS) identified a trend toward declining fertility in some sub-Saharan African countries, the exact beginning of the trend and the rate of transition across the country remain unclear. The authors of this study used methodology exploiting urban and rural yearly fertility trends applied to DHS and other reliable data to learn more about the exact timing of fertility decline in the region. Identification of the initiation of fertility decline permits the in-depth analysis of the process's determinants. Following a review of fertility transition in Kenya, the method is applied to more than 20 other countries. Study results show that fertility began to decline in many countries during the late 1960s and 1970s in urban areas, compared to approximately 10 years later in rural areas, far earlier than previously thought. Focus is given to the role of family planning programs and individual behavior changes such as delayed marriage and abortion. Comparisons are made with other developing countries and the potential role of mass media.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 165582.Article de périodique
Kaye D.
Domestic violence and induced-abortion: report of three cases
2001 - East African Medical Journal, 78(10), p. 555-556
Mots clés : enquête; grossesse non prévue; grossesse non désirée; violence; avortement; droit; femme; étudiant; scolarisation; méthodologie; collecte; santé de la reproduction; fécondité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Domestic violence not only violates women's rights, but is also associated with diverse consequences ranging from physical injury to psychological morbidity. Several studies have associated domestic violence with risk of having an induced-abortion. The following three cases indicate that domestic violence may not cause unwanted pregnancy, but may be the reason that leads victims to resort to abortion. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 163072.Thèse
Anoh A.
Émergence de la planification familiale en Côte d'Ivoire
2001 - Démographie, Paris X, Nanterre, 244
Source : Source : Ceped http://ceped.cirad.fr.Ouvrage
Ould Isselmou A.; Barrère B.; Salem Ould Moujtaba M.L.; Housni E.H.; Ould Ekeibed M.A.; Barrère M.; Mboup G.; Office National de la Statistique (Mauritanie); ORC Macro
Enquête démographique et de santé Mauritanie 2000-2001
2001 - Calverton (US): ONSORC Macro, 385 p. p.
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Letaief M.; Bchir A.; Belghith Z.; Ben Salem K.; Soltani M.S.
Epidemiological aspects of induced abortion in Monastir, TunisiaAspects epidemiologiques de l'interruption volontaire de grossesse a Monastir, Tunisie
2001 - Archives of Public Health, 59(2), p. 101-110
Mots clés : avortement; contraception; méthode contraceptive; facteur démographique; programme planning familial; enquête; santé de la reproduction; méthodologie; planning familial; contraception d'urgence; contraception postcoitale; santé; population; programme; étudiant; scolarisation
Pays / Régions : Tunisie; Afrique; Pays arabes; Afrique Francophone; Pays Méditerranéens; Afrique du NordRésumé : In Tunisia, a family planning (FP) program has been launched since 1966 and contributed to the improvement of sociodemographic indicators. However, induced abortion remains frequent. The authors' study aims to present sociodemographic characteristics, obstetrical profile, contraceptive use and mode of recourse to abortion among 597 women attending a FP center. A prospective study was carried out during the first semester 1998 in Monastir, Tunisia. Information was collected by interviewers using a questionnaire. The mean age of the study population was 32 years confidence interval (CI) 95% [31.5-32.5], 75% were below 36 years and have been married for a mean period of 10 years CI 95% [9.5-10.5]. 42.9% experienced one (30.0%) or more (12.9%) previous induced abortion. Contraceptive use 1 month before the conception showed that 61% of women had used several traditional contraceptive methods i.e. rhythm by 43.4% CI 95% [35.1-51.7], withdrawal method by 12.1% CI 95% [9.4-14.9] and breastfeeding by 5.1% CI [3.3-6.9]. About 25% of women had used modern contraceptive methods: 11.1% CI 95% [8.65-13.6] a contraceptive pill, IUD in 5.8% of cases CI 95% [3.9-7.7], only 5.3% CI 95% [3.5-7.1] reported use of condoms and other methods including spermicide and injectable contraceptive were used in 3.0% of cases. 14% declared not using any method. The most frequent reasons cited for not using any modern contraceptive methods were: fear of side effects (42.0%), careless (19.0%), refuse (17.0%) and lack of information (12.0%). These results showed that many efforts should be deployed in knowledge about contraceptive use, couple involvement and on health service integration to improve the quality of care in reproductive health. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 170908.Article de périodique
Moussa A.
Evaluation of postabortion IUD insertion in Egyptian women
2001 - Contraception, 63(6), p. 315-317
Mots clés : avortement spontané; fausse couche; adolescence; adolescent; adulte; âge; femme; homme; grossesse
Pays / Régions : EgypteRésumé : This study was carried out at Alhussein University Hospital and Elmonera General Hospital to assess the safety and efficacy of intrauterine device (IUD) insertion immediately after spontaneous abortion compared with insertion 2 weeks after abortion. One hundred women between ages 18 and 40 years were recruited from those admitted via the emergency room with first trimester spontaneous abortion. All women were counseled about a method of contraception, particularly copper T-380, and divided into two groups: Group I, which included 69 women who preferred immediate IUD insertion, and Group II, which included 31 women who asked for late IUD insertion 2 weeks after an abortion. All women were followed at 2, 6, and 10 weeks after insertion of IUDs. Bleeding patterns were comparable in both groups. Mild bleeding occurred in 9.2% and 16% in Groups I and II, respectively; moderate bleeding occurred in 80% and 64%, respectively, and severe bleeding was observed in 10.8% and 20%, respectively. This was not significant. Expulsion rate was 4.5% and 3.4% in Groups I and II, respectively, which was also not significant. There were no cases of perforation or pelvic infections. This study showed that insertion of an IUD immediately after a spontaneous abortion is safe and could be offered to those who have had an abortion and who ask for a method of contraception.
Source : Abstract from CONTRACEPTION, V63(6): 315-17, Moussa A. : "Evaluation of postabortion IUD insertion in Egyptian women" © 2001 Elsevier Inc.Article de périodique
Tadesse E.; Yoseph S.; Gossa A.; Muletta E.; Pogharian D.
Illegal abortions in Addis Ababa, Ethiopia
2001 - East African Medical Journal, 78(1), p. 25-29
Mots clés : méthodologie; loi; demande; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : Unsafe abortion is one of the greatest neglected problems of health care in developing countries and is a major medical and public health problem in Ethiopia. In this perspective, a cross-sectional hospital-based multi-center study was undertaken to identify the primary abortionist while the patient is in the hospital. Also, the study aims to determine the type of materials used to terminate the pregnancy, the number of attempts made to terminate the index pregnancy and to characterize the women with induced abortions at 5 hospitals in the city of Addis Ababa. A total of 2275 cases of abortion had been admitted to the study hospitals with obstetric and gynecologic services. The study demonstrated that 984 (43.3%) were spontaneous abortions. Of the 1290 illicit or unsafe abortions, 455 (35.3%) were performed by health assistants, 366 (28.4%) self-induced and 306 (23.7%) by non-medical people (cleaners). High doses of ampicillin per OS (32.3%) and inserting plastic tubes per vagina (32.1%) were identified as the most commonly used methods for inducing abortion. The study provides evidence that unsafe abortion carries a high risk of complications, permanent damage and even death where abortion is illegal or not readily available.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 159963.Congrès
Guengant J. P.; May J.F.
Impact of the proximate determinants on the future course of fertility in sub-Saharan Africa
2001 - Prospects for Fertility Decline in High Fertility Countries, New York, 24 p.
Mots clés : fécondité
Source : source : Ceped.Article de périodique
Ahiadeke C.
Incidence of induced abortion in southern Ghana
2001 - International Family Planning Perspectives, 27(2), p. 96-101, 108
Mots clés : méthodologie; enquête; demande; facteur socio-économique; taux; loi; avortement; contraception d'urgence; contraception postcoitale; planning familial; facteur économique
Pays / Régions : Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In countries such as Ghana, where the law restricts elective induced abortion, data to quantify the incidence of abortion are scarce. Existing data on induced abortions in Ghana come mainly from hospital records, which are unreliable because record-keeping is poor and induced abortions often are classified inaccurately. A multistage random sampling design was used to identify 18,301 women aged 15-49 from eight communities in four of the 10 regions in Ghana between January and March 1997. Of the identified women, 1689 were pregnant. From March 1997 to March 1998, fieldworkers living in the pregnant women's communities monitored their health and pregnancy outcomes, including self-induced abortions. During the study period, the rate of abortion in the study areas was 17 induced abortions per 1000 women of childbearing age. There were 19 abortions per 100 pregnancies (or 27 abortions for every 100 live births). The majority (60%) of women who had an abortion were younger than 30, and 36% were nulliparous. 45% had obtained their abortions before the 7th week of gestation, and 90% had done so before the 10th week. Only 12% of the women said they had obtained their abortion from a physician. Muslim women had decreased odds of obtaining abortion. Women who lived in urban areas, who were educated, or who had four or more children had increased odds of obtaining an abortion. Women who were self-employed had greater odds of obtaining an abortion than those who were employed by someone else. Ghana's abortion law does nothing to prevent many induced abortions from occurring. However, few Ghanaian women who seek abortions obtain them from physicians, and most appear to induce abortions themselves, often in collaboration with pharmacists. (author's)
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2709601.html.Thèse
Jossaume C.
Introduction à la santé publique. Etude des indicateurs de santé de la reproduction en Afrique subsaharienne; cas particulier du Bénin. .
2001 - s.l, 93
Mots clés : contraception; méthode contraceptive
Pays / Régions : Bénin
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Capo chichi V.; Juarez F.
Is fertility declining in Benin?
2001 - Studies in Family Planning, 32(1), p. 25-40
Mots clés : méthodologie; taux fécondité; transition fécondité; déterminant fécondité; intervalle naissance; éducation; femme; taux natalité; fécondité; population; facteur démographique; planning familial; facteur socio-économique
Pays / Régions : Bénin; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : This study analyzes reproductive changes in Benin, a West African country with high fertility and low prevalence of use of modern contraceptive methods, using a combination of quantitative and qualitative approaches. Findings indicate that an irreversible fertility transition has started as the result of an emerging pattern of birth limitation and continued desire for the traditional long birth intervals. The data suggest that changes in childhood mortality in combination with an increase in women's education, although modest, have created a demand for fertility control among women; that induced abortion may be one of the means through which such demand is being met, particularly in urban areas; and that the economic crisis of the 1980s was the main catalyst that precipitated the onset of transition. Changes in reproductive preferences and practice suggest a diffusion process, from urban and more educated women to rural and less-educated ones. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156231.Congrès
Rossier C.; Pictet G.; Ouedraogo C.M.
Is modern contraception the same as induced abortion? Discourses on different forms of birth control and visions of reproduction in rural Burkina Faso
2001 - IUSSP seminar on The Production and Circulation of Population Knowledge, Brown University Population Studies and Training Center, Providence, RI, 38 p. p.
Pays / Régions : AfriqueRésumé : This paper examines why modern contraception and induced abortion hold a similar place in the traditional Mossi (rural Burkina Faso) view of reproduction, and how this is changing. Using qualitative data, this paper first assesses the diversity of opinions on the two methods of birth control in the population under study. Qualitative analysis led us to distinguih two main groups of respondents. First, the "traditionalists" either condemn or accept both contraception and abortion together. For them, abortion, as contraception, has an ambivalent meaning: these practices are condemned as the marker of dishonorable sexual conduct, but tolerated as a means of avoiding the shame of unappropriate pregnancies. "Innovators", on the other hand approve of contraception but condemn abortion. Innovators adopt the classifications promoted by international family planning discourses; in this instance, global and local visions of birth control are linked. Further analysis found that three main factors underlie the observed diversity: value attributed to early life, belief in reproductive predestination, and attitude towards abstinence. Opinions on abortion and contraception are embedded in representations of human personhood, individuality and sexuality.
Source : source : ceped.Article de périodique
Siringi S.
Kenyan government admits to high maternal death rates
2001 - Lancet, 358(9292), p. 1523
Mots clés : législation; taux mortalité; décès; femme; mortalité maternelle; complication grossesse; avortement; facteur politique; mortalité; population; facteur démographique; maladie; complication; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Government figures that were released on October 24 indicate that at least 700 women in Kenya die annually from pregnancy-related complications. The Chairman of the Parliamentary Committee on Health, Newton Kulundu, claimed that more than half the deaths resulted from complications during or after abortion, which is illegal in Kenya. It is in this context that Kulundu wants the government to introduce a policy legalizing abortion and stating where, by whom, and under what conditions abortion can be performed. Moreover, Abdullah Wako, the Medical Services Assistant Minister of Kenya, urged Parliamentary Committee members to act independently and bring a motion to the House to amend the law against abortion. On the other hand, the government plans to conduct a national health services conference to discuss the proposal on legalizing abortion although it has been rejected by churches.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 161894.Ouvrage
Ouedraogo C.M.; Pictet G.
La pilule est-elle une alternative à l'avortement en milieu rural africain ?
2001 - Ouagadougou (BF): UERD, 55 p. p.
Pays / Régions : Burkina FasoRésumé : Les femmes du Bazèga, province rurale du Burkina Faso, préfèrent-elles l'avortement à l'utilisation des méthodes contraceptives comme moyen de contrôle des naissances ? De leur point de vue, il y a plus d'avantages à avorter qu'à recourir aux contraceptifs modernes. La pilule est même utilisée comme une méthode d'avortement. Les représentations relatives à la reproduction humaine ainsi que les perceptions des méthodes contraceptives modernes concourent à cette préférence. Néanmoins, des signes de changement sont perceptibles dans les comportements en matière de fécondité. Ces changements laissent présager une plus grande autonomie des couples et facilitent l'innovation dans le contrôle des naissances, qui, à terme, favorisent l'utilisation de la pilule (Résumé d'auteur)
Source : Source Ceped : http://ceped.cirad.fr.Rapport
Ayad M.; Jemai H.
Les déterminants de la fécondité
2001 - Population et développement en Tunisie. La métamorphose, Tunis (TN), Tunis (TN), 171-201
Mots clés : méthodologie; déterminant fécondité; transition fécondité; fécondité; population; facteur démographique; facteur socio-économique
Pays / Régions : Tunisie; Afrique Francophone; Afrique; Afrique du Nord; Pays arabes; Pays MéditerranéensRésumé : Tunisia is one of the first developing countries to have recognized from its first years of independence the importance of demographic equilibrium in development. As such, the country waged a structured and long-term campaign to reduce population growth through a fertility control program. That effort consisted of a combination of political, legal, institutional, health, and demographic measures conducted to progressively manage population growth. Between 1964, the year Tunisia's national family planning program was launched, and 1995, the year in which the most recent national maternal- child health survey was conducted, Tunisia's overall fertility level declined from over 7 children per woman to only 3 children/woman, an almost 60% reduction over 30 years. Such steep fertility decline is unparalleled in Africa and the Middle East, with the exception of Mauritius. The authors analyze the determinants of fertility decline in Tunisia in the following sections: the framework and social factors supporting fertility transition in Tunisia, fertility levels and trends, proximate fertility determinants, and the explanatory analysis of fertility variations. Social and legal reforms played a strong role in the success of this fertility transition. They provided the key framework to realizing birth control program target objectives. Among those measures, rising educational status and improving women's status were the most important factors in ultimately reducing fertility.French Abstract: La Tunisie est un des premiers pays en développement à avoir compris dès les premières années de son indépendance de l'importance de l'équilibre démographique dans le processus de développement. C'est ainsi qu'elle s'est engagée dans une campagne structurée et de longue durée visant à réduire l'accroissement démographique à travers un programme de régulation de la fécondité. Cet effort comprend un ensemble de mesures politiques, juridiques, institutionnelles, sanitaires, et démographiques qui ont conduit à la maîtrise progressive du croît démographique. Entre 1964, l'année du lancement du programme national de planification familiale au pays, et 1995, l'année dans laquelle la dernière enquête nationale sur la santé de la mère et de l'enfant a été conduite, le niveau de la fécondité en Tunisie est passé de plus de sept enfants par femme à trois enfants par femme, une réduction de près de 60% en l'espace de trente ans. L'intensité de cette baisse ne connaît aucun égal ni en Afrique ni au Moyen Orient, à l'exception de l'Ile Maurice. Les auteurs analysent les déterminants de la baisse de fécondité en Tunisie dans les sections de document suivantes : le cadre et les facteurs sociétaux de la transition de la fécondité en Tunisie, les niveaux et les tendances de la fécondité, les déterminants proches de la fécondité, et l'analyse explicative des variations de la fécondité. Des réformes sociales et législatives ont joué un fort rôle dans le succès de cette transformation en fécondité. En effet, elles ont fourni le cadre clé à la réalisation des objectifs visés par le programme de limitation des naissances. Parmi ces mesures, l'élévation des niveaux d'instruction et l'amélioration du statut des femmes ont été les facteurs les plus importants dans la réalisation de la baisse de la fécondité.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 165955.Article de périodique
Hord C.E.
Making safe abortion accessible: a practical guide for advocates
2001
Mots clés : médicament; loi; programme; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : At the International Conference on Population and Development (ICPD) in Cairo and a follow-up UN meeting held in 1999 to review progress toward the commitments made in Cairo ("ICPD+5"), a majority of the world's governments pledged to ensure that abortions permitted by law are safe and accessible. This guide offers direction to activists who want to ensure that this mandate is realized in their countries. It presupposes that the reader wants to make abortion services in her/his country safe, affordable, and available to women who seek them, and it provides an overview of the issues that must be addressed to do so. The guide is broken into four primary sections: Section 1-envisioning how you want to see abortion services change in your country; Section 2-finding partners to help your goals, and planning your work; Section 3-spreading awareness of the need for change among a variety of audiences; and Section 4- helping prepare the health system and related sectors to offer safe abortion services. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 168068.Article de périodique
Olatunji A.O.; Sule Odu A.O.
Maternal mortality at Sagamu, Nigeria--a ten year review (1988 - 1997)
2001 - Niger Postgrad Med J, 8(1), p. 12-15
Mots clés : avortement; mortalité; décès
Pays / Régions : NigeriaRésumé : A review of maternal deaths at the Ogun State University Teaching Hospital, Sagamu, Nigeria over a 10 year period is presented. During the period, there were 92 maternal deaths, those from abortion and ectopic pregnancy inclusive. The total deliveries were 5423 giving a maternal mortality ratio of 1700 per 100,000. Ruptured uterus was the most common cause followed by eclampsia, postpartum haemorrhage and complications of abortion in that order. Unbooked patients constituted about one third of the total (29. 1 %). Primipara and grandmultipara were the most at risk of maternal death and the risk of dying following operative delivery was six times that of vaginal delivery. Easy access to affordable antenatal care, good blood transfusion services, more widespread use of contraceptives and training of traditional birth attendants would help reduce the risk of maternal death.
Source : source : Niger Postgrad Med J.Article de périodique
Rogo K.O.; Aloo Obunga C.; Ombaka C.; Oguttu M.; Orero S.; Oyoo C.; Odera J.
Maternal mortality in Kenya: the state of health facilities in a rural district
2001 - East African Medical Journal, 78(9), p. 468-472
Mots clés : évaluation; mortalité maternelle; rural; résidence; service de santé; programme; mortalité; population; facteur démographique; soin; santé
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A study was conducted in Siaya District in Kenya to assess the existing state of health facilities, their level of function, and factors influencing their utilization. The Prevention of Maternal Mortality Network study design was used in this study. Qualitative data were obtained from focus group discussions of health service providers and managers from 30 health facilities. Findings revealed the inadequacy of the health facilities in offering quality maternal care, inaccessibility of the main referral system, and poor quality of most services offered. Moreover, geographical distribution, accessibility of emergency obstetric care facilities, and proportion of women with complications who are treated in the health facilities are among the factors noted to influence health services utilization. Overall, both quality of care and record keeping are noted to be well below the acceptable standards. These results indicate the need to address the widening gap in the provision of basic service to reduce maternal mortality.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 162164.Congrès
Lara D.; Ellerston C.; Diaz C.; Stickler j.
Measuring the prevalence of induced abortion in mexico city: comparison of four methodologies
2001 - ¨XXIV IUSSP General Conference, Salvador Brazil, p.Résumé : Objectives : We compare four methods of collecting information on abortion through survey research to measure the levels of induced abortion in Mexico. Methods : We tested four methods for collecting data on abortion attempts: face-to-face interview (FTF), Audio Computer-Assisted Self-Interview (ACASI), self-administered questionnaire (SAQ), and a random response technique (RRT). We tested all methods in three samples: 1) hospital patients in Mexico City; 2) rural women in Chiapas; and 3) women randomly chosen as part of a house-to- house survey in Mexico City Results : In each of the three samples, RR T found the highest rate of attempted induced abortion (21.7% in hospital sample, 36.1 % in rural sample and 17.9% in household sample), followed by the SAQ (19.3% (hospital), 10.1 % (rural) and 10.8% (household". The ACASI and FTF interviews yielded fewer reported abortion attempts. Conclusion :The RRT seems the most promising methodology to measure the levels of induced abortion. With SAQ, we obtained detailed information and the reported frequency rates were slightly lower than the RRT rates in urban areas.
Source : source : Ceped.Article de périodique
Brown B.
Medical abortion at home
2001 - International Family Planning Perspectives, 27(3), p. 110
Mots clés : taux grossesse; médicament; RU-486; méthode; Misoprostol; méthode; taux fécondité; fécondité; population; facteur démographique; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Viet Nam; Tunisie; Asie; Afrique Francophone; Afrique; Afrique du Nord; Pays arabes; Pays MéditerranéensRésumé : A simplified medical abortion regimen is effective, safe and acceptable to women in less-developed countries. Women seeking termination of an early pregnancy were given 200 mg of mifepristone, rather than the standard 600 mg dose, and the option to administer misoprostol themselves at home. Of the 120 Vietnamese and 195 Tunisian women who participated in the study, 93% and 91%, respectively, had successful abortions. Nearly 90% of women chose home administration. In both countries, women who chose clinic administration were more likely to have had unsuccessful abortions than were women who chose home administration (20% vs. 4% in Vietnam and 12% vs. 7% in Tunisia). According to the researchers, side effects, including heavy bleeding, pain and cramps and nausea and vomiting, were not severe. Overall, 78% of women who administered misoprostol at home said they were very satisfied or somewhat satisfied with the method, compared with 14% of women who chose clinic administration. Regardless of administration location, only 2% of women said they were unsatisfied with the method. Women who chose home administration said it was more compatible with their home or work life, that they were more comfortable at home and that returning to the clinic was inconvenient. The researchers conclude that "home administration of misoprostol offers women more choice, control and privacy in managing their abortions". (full text)
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/.Article de périodique
Remez L.
Medical abortion regimen with reduced mifepristone dose, home misoprostol use is feasible and effective
2001 - International Family Planning Perspectives, 27(4), p. 210-211Résumé : This document reports on a prospective study conducted among Vietnamese and Tunisian women seeking abortion. Data were collected from a sample of 120 pregnant women seeking surgical terminations in a clinic in Ho Chi Minh City, Vietnam, and 195 women in Tunis, Tunisia, from December 1997 through December 1998. While all participants received mifepristone from a clinic provider, they were given the choice of returning to the clinic 2 days later for their oral tablet of misoprostol or taking it on their own at home after the same time interval. At both study sites, procedure failure accounted for a greater proportion of unsuccessful terminations than did user or provider failure. The failure rate was much higher among women who received misoprostol at a clinic than among those who took it at home. The study results indicate that a regimen of medical abortion involving one- third the usual dose of mifepristone and fewer clinic visits appears to be successful and acceptable as the standard mifespristone-misoprostol regimen.
Source : Reproduced with the permission of The Alan Guttmacher Institute http://www.agi-usa.org/pubs/journals/2721001.html.Article de périodique
Oguttu M.; Odongo P.
Midlevel providers' role in abortion care. Kenya country report
2001
Mots clés : programme de santé; foeticide; régulation menstruelle; soin post-abortum; personnel de santé; politique; programme; avortement; contraception d'urgence; contraception postcoitale; planning familial; programme planning familial; soin; santé
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Having nurse/midwives provide post abortion care (PAC) services has been found to be beneficial on many fronts. Many private nurse/midwives facilities are located in the communities that they serve, providing easy access for clients. Having emergency PAC services available within the community can be life saving and reduces the burden on referral sites. Additionally, the providers often have positive interpersonal relationships with their clients. The PAC services provided by nurse/midwives in primary level clinics are of high quality and reasonably priced. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 174369.Congrès
van der Westhuizen C.
Midwifes' roles in expanding access to and the management of safe abortion care. South African country report.
2001 - "Expanding Access: Advancing the Roles of Midlevel Providers in Menstrual Regulation and Elective Abortion Care," Kwa Maritane Lodge, Pilanesberg National Park, South Africa,, unpublished, 17 p.
Mots clés : personnel de santé; santé; sage-femme; personnel de santé; santé de la reproduction; programme de santé; service de santé; soin; programme; politique; programme
Pays / Régions : Afrique du Sud; Afrique Anglophone; Afrique; Afrique Australe; Afrique SubsaharienneRésumé : This report draws upon the work of researchers from the Women's Health Project, the Reproductive Research Unit and Ipas, summarising the main activities undertaken in the Midwifery Abortion Care Training Programme (1998-2000), the first programme in South Africa to train midwives to provide abortion services as part of the National Abortion Care Programme. Their paper also outlines major findings of an evaluation of the quality of midwives' practices and presents recommendations for continuing and strengthening training and supervision of midwives in abortion care throughout South Africa. The focus of this report is on advancing the role of the registered midwife in the rendering of safe elective abortion care in South Africa. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 174371.Article de périodique
Mtonga V.; Ndhlovu M.
Midwives' role in management of elective abortion and post-abortion
2001
Mots clés : adolescence; adolescent; sage-femme; personnel de santé; soin; service de santé; avortement; soin post-abortum; connaissance, attitude; pratique; CAP; attitude; perception; programme de santé; législation; étudiant; scolarisation; méthodologie; jeune; adolescent; âge; population; facteur démographique; personnel de santé; santé; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement; politique; programme
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Zambian midwives can participate in the provision of quality abortion services in many different ways even if the law is restrictive. They can offer counselling and family planning services. Now that the 1997 Nurses Act has been passed they can save lives of women who come in with complication of abortions by providing the full PAC package which includes performing MVA. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 174349.Article de périodique
Libombo A.; Usta M.B.
Mozambique abortion situation. Country report
2001
Mots clés : adulte; âge; femme; mortalité maternelle; rural; résidence; santé de la reproduction; avortement; service de santé; programme de santé; âge; population; facteur démographique; mortalité; santé; contraception d'urgence; contraception postcoitale; planning familial; soin; politique; programme
Pays / Régions : Mozambique; Afrique Lusophone; Afrique; Afrique de l'Est; Afrique SubsaharienneRésumé : The success of midlevel providers offering post abortion care services may provide an opportunity to expand low cost service provision to safe abortion services when legal limitations are removed. The impact of safe abortion services on maternal mortality and morbidity could be significant. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 174370.Article de périodique
Touko A.; Kemmegne J.; Nissack F.; Schmidt Ehry B.; Kamta C.
Planning familial chez les adolescentes mères d'enfants dans un centre urbain au Cameroun
2001 - African Journal of Reproductive Health, 5(2), p. 105-115Résumé : This study was carried out in Yaounde (Cameroon) in 1995 to determine the knowledge, attitude and behavior to teenage mothers towards family planning (FP). The study was based on a questionnaire administered at household level drawn from previously determined clusters. It was accomplished by recruiting 462 teenage mothers with ages ranging from 14-19 years and who had 1-3 children. On the whole, 93.9% had heard of FP, 72.5% had heard of FP centers, but only 43% had been to one of these centers at least once. With regards to contraceptive prevalence, 62.1% affirmed the use of a contraceptive method at the time of the study with periodic abstinence being the most widely used (35.9%). Besides the common methods, some teenage mothers made use of herbal concoctions and vaginal douching, sometimes with permanganate or the taking of tablets. 19% of respondents had had between 1 and 4 episodes of induced abortion. According to these teenagers, the ideal average age for first delivery is 19.7 +or- 2.5 years, whereas that of nubility is 22.8 +or- 3.3 years, a difference of 3 years. This suggests that on the whole, teenage mothers believe that first delivery must precede marriage. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 160546.Article de périodique
Ralisata L.R.; Rabenjamina F.R.; Razafintsalama D.L.; Rakotonandrianina E.; Randrianjafisamindraokotroka N.S.
Postabortion peritonitis and pelvi-peritonitis at the Androva Mahajanga University Hospital: 28 casesLes peritonites et pelvi-peritonites post-abortum au CHU d'Androva Mahajanga: a propos de 28 cas
2001 - Journal de Gynecologie, Obstetrique et Biologie de la Reproduction, 30(3), p. 282-287
Mots clés : mortalitéRésumé : In many underdeveloped countries, illegal abortion can lead to death or sequelae. Pregnancy termination is illegal in Madagascar except for medical reasons. The authors report 23 cases observed between April 1990 and December 1994 at the Androva Mahajanga University Hospital. Postabortion infectious complications ranked 19th for hospital admissions. Peritonitis was the most frequent (70%) and most serious complication. The women were young (mean age, 24 years; 44% under age 20). 30% were primigravidas and had poor living conditions (74% were homemakers and 13% were students; 44% were single). Clinical signs were malodorous loss and abdominal pain. A surgical procedure was performed in 74% of the cases: 3 salpingo-oophorectomies, 2 hysterectomies, and 10 uterine sutures. Mortality was high (13%). Illegal abortion must be prevented with better information on contraception and better health education programs. The question of the usefulness of current legislation is discussed. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 158038.Article de périodique
Anochie I.C.; Ikpeme E.E.
Prevalence of sexual activity and outcome among female secondary school students in Port Harcourt, Nigeria
2001 - African Journal of Reproductive Health, 5(2), p. 63-67
Mots clés : méthodologie; étudiant; scolarisation; adolescence; adolescent; jeune; adolescent; femme; école; scolarisation; sexualité; prévalence; éducation; âge; population; facteur démographique; comportement; mesure
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Sexual activity among 534 Nigerian female secondary school students was studied using self-administered questionnaire. Prevalence of sexual intercourse was 25.7%. There was no significant difference between the junior (48.2%) and senior (51.8%) students (p > 0.05). 17 (12.4%) students had initiated sexual intercourse before 11 years. The frequency of sexual exposure was high, with 34.3% of the students having intercourse more than once in a week. Pregnancy rate among sexually active females was 27.0%, with 24.8% rate of induced abortion. Early sexual health education starting from primary school would be helpful in influencing the reproductive decisions and sexual behavior of the students, including contraceptive acceptance and usage, to avoid teenage pregnancy. Education of parents is also recommended in order to overcome the cultural barriers that discourage parents from providing sex education to their children at home. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 160541.Congrès
Bozon M.; Hertrich V.
Rapports de genre et initiation sexuelle en Afrique et en Amérique Latine Une comparaison de 20 enquêtes EDS
2001 - Colloque International "Genre population et développement en Afrique", Abidjan, 28 p p.
Source : source : ENSEA.Article de périodique
Uygur D.; Erkaya S.
Reasons why women have induced abortion in developing countries
2001 - European Journal of Gynecology Obstetrics and reproductive Biology, 96(211-214
Mots clés : éducationRésumé : The immediate explanation that women often give for seeking induced abortion is that the pregnancy was unplanned or unwanted. However, the myriad social, economic and health circumstances that underlie such explanations have not yet been fully explored. We wanted to evaluate these factors that lead one to have an abortion. This prospective study was performed on 588 women applied to our family planning unit to obtain an abortion.
Source : source : European Journal of Gynecology Obstetrics and reproductive Biology.Ouvrage
Van de Walle E.; Renne E.P.
Regulating menstruation : beliefs, practices, interpretations
2001 - Chicago ; London: University of Chicago Press, 292 p.
Mots clés : menstruation; anthropologieRésumé : Menstruation, seen alternately as something negative--a "curse" or a failed conception--or as a positive part of the reproductive process to be celebrated as evidence of fertility, has long been a universal concern. How women interpret and react to menstruation and its absence reflects their individual needs both historically as well as in the contemporary cultural, social, economic, and political context in which they live. This unique volume considers what is known of women's options and practices used to regulate menstruation--practices used to control the periodicity, quantity, color, and even consistency of menses--in different places and times, while revealing the ambiguity that those practices present. Originating from an Internet conference held in February 1998, this volume contains fourteen papers that have been revised and updated to cover everything from the impact of the birth control pill to contemporary views on reproduction to the pharmacological properties of various herbal substances, reflecting the historical, contemporary, and anthropological perspectives of this timely and complex issue.
Source : Source : Ceped.Article de périodique
Jewkes R.; Vundule C.; Maforah F.; Jordaan E.
Relationship dynamics and teenage pregnancy in South Africa
2001 - Social Science Medicine, 52(5), p. 733-744
Mots clés : santé sexuelle; grossesse adolescente; violence
Pays / Régions : Afrique du SudRésumé : Teenage pregnancy is extremely common in South Africa. Whilst its `problematic' nature is a subject of debate, it reflects a pattern of sexual activity which puts teenagers at risk of HIV. Currently one in five pregnant teenagers is infected with the virus. This creates a new imperative to understand teenage pregnancy and the pattern of high risk sexual activity of which it is one consequence. This was an exploratory study undertaken to investigate factors associated with teenage pregnancy amongst sexually active adolescents in an urban and peri-urban context. The study used a matched case control design, with 191 cases and 353 school or neighbourhood, age-matched controls. Subjects were under 19 years and recruited from township areas of Cape Town. A structured questionnaire was used to obtain information on socio-economic factors, contraceptive knowledge and use, and sexual behaviour. Conditional logistic regression was used to analyse the relationship between teenage pregnancy and the factors investigated. The results presented focus on relationship dynamics and their association with the risk of pregnancy. Both groups of teenagers had been dating for a mean of two and a half years and about half were still with their first sexual partner. The partners of the pregnant teenagers were significantly older, less likely to be in school and less likely to have other girlfriends. The pregnant teenagers were significantly more likely to have experienced forced sexual initiation and were beaten more often. They were much less likely to have confronted their boyfriend when they discovered he had other girlfriends. Multiple modelling shows that both forced sexual initiation and unwillingness to confront an unfaithful partner are strongly associated with pregnancy and also related to each other. We argue that the associations are mediated through unequal power relations within the relationship which are reinforced by violence. We further discuss indicators of greater intimacy within relationships of the pregnant teenagers which may suggest that more of the pregnancies were wanted than was suggested. Both of these conclusions pose critical challenges for health promoters.
Source : Source : Social Science Medicine.Article de périodique
Anonymous
Research to stimulate policy dialogue on unsafe abortion in East and Southern Africa
2001
Mots clés : avortement; loi; soin post-abortum; politique; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé
Pays / Régions : Afrique de l'Est; Afrique du Sud; Afrique Subsaharienne; Afrique; Afrique Australe; Afrique AnglophoneRésumé : The US Agency for International Development's Bureau for Africa/Office of Sustainable Development asked the Commonwealth Regional Health Community Secretariat (CRHCS) to review regional literature and conduct a study of hospitals in Malawi, Uganda, and Zambia on the extent, cost, and quality of services for postabortion care. This brief paper highlights key findings of the CRHCS research on: 1) magnitude of unsafe abortion; 2) cost; 3) contraception and abortion; and 4) abortion laws. The research findings provided the first systematic, comprehensive description of abortion-related problems, clinical issues, contraception and abortion, male perspectives, and legal aspects. This activity also affirmed that working with a regional institution improved the chances of affecting policy changes.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 168106.Congrès
Guengant J. P.; May J.F.
Revisiting the African fertility exception
2001 - Annual meeting of the Population Association of America : session 76 : the future of fertility in the next 50 years, USA, 25 p.
Mots clés : contraception; méthode contraceptive
Source : Source : Ceped.Article de périodique
Streatfield P.K.
Role of abortion in fertility control
2001 - Journal of Health, Population and Nutrition., 19(4), p. 265-267
Mots clés : enquête; fécondité; grossesse non prévue; grossesse non désirée; avortement; contraception; méthode contraceptive; population; facteur démographique; santé de la reproduction; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Bangladesh; Asie du Sud; AsieRésumé : Abstract: The subject of this commentary concerns the interrelationship between abortion and contraceptive use in the control of fertility. There is sufficient historical evidence to conclude that no societies have achieved low fertility without recourse to use of some form of contraception together with abortion. In the historical experience, it is noted that as contraception becomes more efficient and attains a substantial level in many societies, abortion rates begin to decline, provided access to contraception is unimpeded. However, some societies have continued to rely primarily on abortion to control fertility, usually with negative consequences in terms of maternal morbidity and mortality. In Matlab, Bangladesh, where high quality contraception services are available, abortion still accounts for about 2% of pregnancies. Furthermore, a study in the area revealed that almost half of the women seeking an abortion over a period of 4 months in 1995 were not using any contraception at all prior to pregnancy. It is concluded that pregnancy-prevention services alone are not enough, but facilities offering safe abortion will continue to be needed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 165985.Congrès
Rossier C.
Testing four methods to estimate the rate of induced abortion in rural Burkina Faso
2001 - Population Association of America Annual Meeting,, Washington D. C., source : Ceped, 37 p. p.
Pays / Régions : AfriqueRésumé : This paper presents the results of the test of four different methods to estimate the rate of clandestine induced abortion in one health district (9 villages, Bazega province) in rural Burkina Faso. The first method is a variation of Bongaart's formula. The second estimate is obtained through women self-reporting their abortions. The third counts cases of abortion that the respondents know about by hearsay. These three first estimates are calculated with survey data (sample = 1000 women). Extensive qualitative work preceded the survey design. The fourth estimate is based on the same information as the third, but collected using ethnographic methods (extensive stay in one village, key informants). Based upon the spread of the four estimates, conclusions will be drawn on the value of each method; possible biases is discussed. An estimation of the rate of induced abortion for the study area in rural Burkina Faso is presented (12 abortion per 1000 women aged 15-44).
Source : source : Ceped.Chapitre d'ouvrage
Chékir H.
Textes juridiques choisis et commentés sur la politique de population en Tunisie.
2001 - Population et développement en Tunisie. La métamorphose., p. 601-617. Tunis (TN): Céres
Mots clés : législation; politique; programme; droit; femme; famille
Pays / Régions : Tunisie; Afrique Francophone; Afrique; Afrique du Nord; Pays arabes; Pays MéditerranéensRésumé : Many different government texts govern population policies. Both international and domestic instruments are among these texts. International legal guidelines include international accords adopted by the UN General Assembly and resolutions upon plans, programs of action, and declarations adopted during recent UN international conferences upon human rights, population and development, and women. National legal texts consist of a body of laws, decrees, and circulars defining the population field from independence and especially those governing families, women, and reproductive and sexual health. Some of these texts, adopted since 1956, remain in force despite various modifications effected over the years. Others arose following the government of Tunisia's adoption of a population policy and address particular aspects of policy. In Tunisia's case, the author describes the legal organization of family life and women's rights within the family regarding marital consent and the rights of married women. Regarding rights associated with the organization and protection of human life, the text explores individual civil status, contraception and abortion rights, and socioprofessional rights of pregnant women and young mothers.French Abstract: Il existe de nombreux textes juridiques diversifiés qui régissent les politiques de population. Parmi ces textes, il y a des instruments internationaux et nationaux. Les instruments juridiques internationaux consistent en des conventions internationales adoptées par l'Assemblée générale des Nations unies et des résolutions sur les plans, les programmes d'action, et les déclarations adoptés au cours des dernières conférences internationales des Nations unies sur les droits de l'homme, la population et le développement, et les femmes. Les textes juridiques nationaux sont constitués d'un ensemble de lois, décrets, et circulaires qui organisent le domaine de la population depuis le début de l'Indépendance et surtout ceux qui régissent la famille, les femmes, et la santé reproductive et sexuelle. Certains de ces textes, adoptés depuis 1956, restent toujours en vigueur malgré leurs différentes modifications au cours des années. D'autres sont apparus avec l'adoption par l'Etat tunisien d'une politique de population et touchent des aspects particuliers de la politique. Pour le cas de la Tunisie, l'auteur décrit l'organisation juridique de la vie familiale et les droits des femmes dans la famille dans les domaines du consentement au mariage et les droits de la femme mariée. Quant aux droits liés à l'organisation et à la protection de la vie de la personne, le texte traite les sujets de l'état civil de la personne, le droit à la contraception et à l'avortement, et les droits socioprofessionnels de la femme enceinte et de la jeune mère.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 165948.Article de périodique
Donohue J.J.; Steven D. l.
The impact of legalized abortion on crime
2001 - Quarterly Journal of economics, CXVI(2 - May 2001), p. 379-420Résumé : We offer evidence that legalized abortion has contributed significantly to recent crime reductions. Crime began to fall roughly eighteen years after abortion legalization. The five states that allowed abortion in 1970 experienced declines earlier than the rest of the nation, which legalized in 1973 with Roe v. Wade. States with high abortion rates in the 1970s and 1980s experienced greater crime reductions in the 1990s. In high abortion states, only arrests of those born after abortion legalization fall relative to low abortion states. Legalized abortion appears to account for as much as 50 percent of the recent drop in crime. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 176924.Article de périodique
Senlet P.; Sian l. C.; Jill M.; Hans R.
The role of changes in contraceptive use in the decline of induced abortion in Turkey
2001 - Studies in Family Planning, 32(1), p. 41-52Résumé : The induced abortion rate in Turkey declined from a peak of 4.5 abortions per 100 women in 1988 to 2.4 in 1998. This study examines the extent to which the decline in abortion in Turkey can be attributed to increased use of modern contraceptives. Trends in induced abortion rates and in contraceptive use are examined among Turkish women together with fertility preferences, changes in the contraceptive behavior associated with abortion, and changes in the propensity to abort unwanted pregnancies. The analysis includes a number of simulations that examine what abortion levels might be in different contraceptive-use scenarios. Results indicate that the decline in abortion is due to a decrease in the number of abortions associated with traditional method failure. This decrease is related to three factors: a shift from traditional method use to modern method use, a decline in the traditional method failure rate, and a decline in the proportion of pregnancies resulting from traditional method failures that are aborted. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156232.Article de périodique
Rutgers S.
Two years maternal mortality in Matebeleland North province, Zimbabwe
2001 - Central African Journal of Medicine, 47(2), p. 39-43
Mots clés : méthodologie; enquête; mortalité maternelle; décès; femme; complication; paludisme; maladie; taux; éclampsie; étudiant; scolarisation; mortalité; population; facteur démographique; maladie; complication; avortement; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The aim was to describe timeliness and completeness of maternal mortality notifications after the introduction of a revised national notification form in 1998, as well as sociodemographic and obstetric variables and causes of maternal deaths. A retrospective descriptive study was conducted in seven districts in Matebeleland North province using 95 maternal death notifications from 1 August 1998 to 31 July 2000. Main outcome measures were delay in submission and completeness of reports, age, marital status, religion, reproductive history, booking and referral status, duration and outcome of pregnancy, place of death, cause of death. 92/95 notifications were true maternal deaths, 86% were notified within 48 hours and 79% were complete, 74% of the deaths took place in a health facility. Mean age of the women was 27.8 years, mean parity 3.0. 60% had booked. The five main causes of death were obstetric hemorrhage (26%), malaria (24%), immune deficiency syndrome (13%), abortion (11%) and eclampsia (8%). The maternal mortality ratio per 100,000 reported home and institutional live births ranged from 155 to 532 per district. There is under reporting of maternal mortality in some districts, although from 1997 to 2000 a 200% increase in reporting was seen. Timeliness and completeness of reporting was satisfactory. With the exception of a high contribution from malaria the causes of maternal mortality in Matebeleland North province are similar to those reported elsewhere in Zimbabwe. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 159749.Article de périodique
Olukoya A.A.; Kaya A.; Ferguson B.J.; AbouZahr C.
Unsafe abortion in adolescent
2001 - International Journal of Gynecology Obstetrics, 75(137-147
Mots clés : législation; loi; complication; mortalité maternelle; incidence; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; mortalité; population; facteur démographique; mesure; méthodologie
Pays / Régions : Singapour; Asie du Sud Est; AsieRésumé : This paper on the influence of abortion legislation on maternal mortality opens by noting that 585,000 women die from pregnancy- and childbirth-related causes each year and that all but about 250 of the 150,000 annual abortion-related deaths are preventable. The next section reviews the incidence of induced abortion (36-51 million each year, with 26-31 million being legal) and provides a table and a figure that reveal that the global incidence of unsafe abortion is approximately 20 million/year, resulting in approximately 70,000 deaths with many more women suffering serious complications that require treatment from seriously strained health care systems. Section 3 categorizes abortion laws as very strict (50 countries), rather strict (44 countries), rather broad (13 countries), and on request (22 countries). The most populous countries tend to have liberal laws, so only 25% of women worldwide have no access to legal abortion and 40% of women can decide for themselves. The next section discusses the fact that liberalizing abortion legislation leads to a tremendous decrease in maternal mortality rates because legalization allows abortion to be performed by trained providers using proper facilities and equipment and because accessibility and information dissemination allows women to seek abortions earlier in pregnancies. Section 5 notes the contrary effect of restrictive abortion legislation on maternal mortality, and section 6 reviews Singapore's experience in liberalizing abortion legislation. The article concludes that safe abortion services will always be needed and should be available worldwide.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 140554.Article de périodique
Otoide V.O.; Oronsaye F.; Okonofua F.E.
Why Nigerian adolescents seek abortion rather than contraception: evidence from focus-group discussions
2001 - International Family Planning Perspectives, 27(2), p. 77-81
Mots clés : méthodologie; adolescence; adolescent; avortement; contraception; méthode contraceptive; information; méthode; perception; jeune; adolescent; âge; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement; communication
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Nigerian adolescents generally have low levels of contraceptive use, but their reliance on unsafe abortion is high and results in many abortion-related complications. To determine why, it is important to investigate adolescents' perceptions concerning the risks of contraceptive use versus those of induced abortion. Data were collected through focus-group discussions held with adolescents of diverse educational and socioeconomic backgrounds. All were asked what they knew about abortion and contraception, and each method of contraception was discussed in detail. In particular, youths were asked about contraceptive availability, perceived advantages of method use, side effects and young people's reasons for using or not using contraceptives. Fear of future infertility was an overriding factor in adolescents' decisions to rely on induced abortion rather than contraception. Many focus-group participants perceived the adverse effects of modern contraceptives on fertility to be continuous and prolonged, while they saw abortion as an immediate solution to an unplanned pregnancy -- and, therefore, one that would have a limited negative impact on future fertility. This appears to be the major reason why adolescents prefer to seek induced abortion rather than practice effective contraception. The need to educate adolescents about the mechanism of action of contraceptive agents and about their side effects in relation to unsafe abortion is paramount if contraceptive use is to be improved among Nigerian adolescents. (author's)
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2707701.html.Article de périodique
Mahjoub S.; Mahbouli S.; Masmoudi A.; Ben hmid R.; Bra A.; Karoui G.; Lebbi I.; Gaigi S.S.; Zouari F.
[Medical termination of pregnancy. Indications, techniques and complications. Report of 55 cases]
2001 - Tunis Med, 79(2), p. 116-122
Source : source Tun med.
1999Article de périodique
Kebede S.; Jira C.; Mariam D.
A survey of illegal abortion in Jimma Hospital, south western Ethiopia
2000 - Ethiop Med J, 38(1), p. 35-42
Mots clés : adulte; âge; planning familial; facteur socio-économique
Pays / Régions : EthiopieRésumé : A cross-sectional descriptive study of induced abortion was conducted in Jimma Hospital, South-western Ethiopia to determine socio-economic factors and associated problems during February 25-May 5, 1996. There were a total of 80 patients with a diagnosis of induced abortion were enrolled of which 50 (62.5%) cases were admitted for bleeding and infections. Thirty six (45%) of all cases were primigravidae. Students accounted for 28 (35%) of the cases. Seventy (87.5%) of the cases could read and write and only 31 (38.8%) were married. Seventy (87.5%) knew presence of family planning methods, and 40 (50%) used at least once previously. Eighteen (22.5%) gave economic problems as reason for abortion, and 76 (95%) of them used either rubber tubes or roots of plants to induce the abortion. Of the total 42 (52.5%) believed that the right of abortion concerns mainly themselves
Source : Source : Ethiopina Medical Journal.Article de périodique
Getahun H.; Berhane Y.
Abortion among rural women in north Ethiopia
2000 - International Journal of Gynecology and Obstetrics, 71(3), p. 265-266
Mots clés : rural; résidence; femme; avortement; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : This study describes the magnitude of abortion in the rural district of South Gonder in north Ethiopia. A total of 1158 women of reproductive age (15-49 years) and who were currently married participated in the study. Lifetime history of abortion was reported by 241 of the women. Of the reported abortions, the majority (91.4%) was spontaneous. Moreover, induced abortion was mainly related to avoidance of pregnancy and poverty. Self-introduction of hard material into the vagina and chloroquine over-dosage were the main methods used for inducing abortion. A history of sexually transmitted disease (P < 0.01) and more than one lifetime marriage (P < 0.01) were associated with an increased risk of abortion. The study indicates that with the rapid growth of population and a decline in agricultural land size per capita in Ethiopia, the rate of induced abortion in rural communities may have a remarkable increase in the near future.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 154333.Article de périodique
Bennett T.
Abortion and human rights in sub-Saharan Africa
2000 - Initiatives in Reproductive Health Policy, 3(2), p. 1-3
Mots clés : droit; femme; loi; facteur économique; avortement; contraception d'urgence; contraception postcoitale; planning familial; facteur socio-économique
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : This issue of Initiatives focuses on the generally restrictive abortion laws in sub-Saharan Africa. It is noted that African women account for at least 34,000 of the total number of female deaths caused by unsafe abortion globally each year. These restrictive abortion laws violate women's rights and, by targeting women uniquely, legal limitations on abortion constitute a form of gender discrimination. The interplay between human and reproductive rights and abortion realities can be seen in the context of the African case studies presented in this issue. These case studies highlight the damaging cycle of women's inequality, in which low social status leads to lack of contraceptive and other preventive health services for women, resulting in unintended pregnancies and utilization of unsafe abortion. Just as human rights are a prerequisite for reproductive freedom and abortion rights for women, the availability of safe abortion services is necessary for full implementation of other rights. Sub-Saharan African women are asserting their reproductive rights to the full extent and sometimes beyond the extent of the law. To support this endeavor, the international community must help to free resources for building the economic and social infrastructures that will make possible the exercise of human rights in the developing world.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 153913.Article de périodique
Guillaume A.
Abortion in Africa: a birth control method and a public health issue
2000 - Ceped News, 8), p. 1-4
Mots clés : adolescence; adolescent; mortalité maternelle; morbidité; avortement; contraception; méthode contraceptive; risque; santé; femme; jeune; adolescent; âge; population; facteur démographique; mortalité; maladie; complication; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : AfriqueRésumé : Induced abortion is an important factor of maternal morbidity and mortality in Africa. Despite often restrictive law systems and very poor sanitary conditions for operations, abortion seems to be on the rise, particularly among the younger generations of women who are either educated or wish to go on with their studies, and in urban environments. An in-depth study conducted in Ivory Coast among women in four health centers in Abidjan, affords greater insight into reasons and methods used for abortion. The survey shows the competition between contraception and abortion, two birth control methods that do not involve the same risks for the health of women. (author's)
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Kasolo J.
Abortion in Uganda
2000 - Initiatives in Reproductive Health Policy, 3(2), p. 9-10
Mots clés : complication; droit; femme; santé; avortement; contraception d'urgence; contraception postcoitale; planning familial; comportement
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Uganda, health care for women is not considered a basic right by society or by women themselves. A woman's worth and prestige are measured by her ability to feed the family; her health is not a priority. They are not allowed to use contraception or any family planning services. Because of their low status and barriers to contraception, many resulted in unwanted pregnancies and unsafe abortion. It is noted that women seek abortion for various reasons, primarily to continue their education, to maintain a job if the man has denied responsibility, or to avoid producing a child outside wedlock or before marriage. The negative societal attitudes about abortion often result in clandestine abortion. It is evident that unsafe abortion causes 20% of maternal deaths. Unless the Ugandan society experiences a shift in attitudes, women's reproductive rights can never be realized. It is suggested that advocacy, greater acceptance of single motherhood, accessible family planning services, and reproductive health policies can decrease the demand for abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 153917.Article de périodique
Mbonye A.
Abortion in Uganda: magnitude and implications
2000 - African journal of Reproductive Health, 4(2), p. 104-108
Mots clés : méthodologie; enquête; mortalité maternelle; risque; service de santé; étudiant; scolarisation; analyse; mortalité; population; facteur démographique; soin; santé
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This study was conducted to assess the magnitude of maternal deaths in health units in Uganda, and the risk factors associated with such deaths. A retrospective study of maternal deaths in 20 hospitals and 54 randomly selected health centers was conducted in 12 randomly selected districts of Uganda. The reference period for documenting maternal deaths was September 1992-September 1993. The International Classification of Diseases 10 was used to define a maternal death. Data on maternal deaths and associated risk factors was obtained from admission and patient case notes. Statistical Package for the Social Sciences/PC was used to carry out advanced statistical analysis. Log linear analysis was used to rank risk factors for maternal deaths. A total of 418 maternal deaths and 75,000 live births were recorded, giving a maternal mortality ratio of 557/100,000 live births. 360 (86.1%) mothers died within 1 hour of admission. The risk factors identified were inadequate antibiotic supply, intravenous drug fluids, and blood for transfusion in health units; non- use of family planning; use of traditional medicine; mothers aged 15-19 and 30- 50 years. Others included those who had a history of two or more abortions and stillbirths; parity of five and above; and living within a distance of more than 10 km to the nearest health unit. The authors conclude that the focus on risk factors for maternal deaths have policy implications. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 165903.Article de périodique
Cohen S.
Abortion Politics and U.S. Population Aid: Coping with a Complex New law
2000 - International Family Planning Perspectives, 26(3), p. 137-145
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2613700.html.Article de périodique
Stevens M.
Abortion reform in South Africa
2000 - Initiatives in Reproductive Health Policy, 3(2), p. 4-6
Mots clés : loi; droit; femme; programme; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In South Africa, the election of a new government in 1994 formalized a growing emphasis on human rights and equality for all. In conjunction with the dismantling of apartheid, the country developed a number of initiatives that supported a rights-based approach to reproductive health care and personal autonomy and laid the foundation for the passage of a liberalized abortion law in 1996. It is noted that the process leading to abortion law reform was complex and multi-faceted. Researchers, activists, community groups, political representatives and religious leaders all contributed to the change. However, despite the improvements in the model human rights framework in which the South African abortion law was created, implementation of legal abortion services is slow and needs careful vigilance to ensure that the needs of ordinary women are met in the South African context. To this effect, health planners and managers need to observe and listen to women's strategies for negotiating their multiple roles and the daily challenges they face. The health sector must also ensure that women know their rights, have access to services, and receive satisfaction and support from their health care.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 153914.Article de périodique
Varkey S.J.
Abortion services in South Africa: available yet not accessible to all
2000 - International Family Planning Perspectives, 26(2), p. 87-88
Mots clés : loi; offre; praticien; prestataire; programme; droit; avortement; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In 1994, the political regime in South Africa ushered in the government's commitment to women's health as indicated in key documents which recognized the woman's right to choose and addressed the problem of clandestine, unsafe abortion. Within this enabling environment, the Choice on Termination of Pregnancy Act was passed in 1996. Since then, research and monitoring initiatives have documented the increased availability of abortion services. However, the question of how accessible these services are remains to be answered. This article evaluates accessibility of services to assess the implementation of three provisions of the Act that were intended to ensure access for all. These provisions include training midwives to perform first-trimester abortions so that services can be provided in primary health care facilities; placing no restrictions on access to services besides individual choice; and ensuring that women have the sole right to consent to an abortion. Overall, the information gathered from various research and monitoring efforts indicates that although the Act has increased availability, the right to abortion remains elusive for certain groups, especially women from peripheral areas and younger women. Concerted effort is recommended to maintain the rights guaranteed by the Act; the right to self-determination and the right to equal access.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2608700.html.Article de périodique
Rasch V.; Silberschmidt M.; McHumvu Y.; Mmary V.
Adolescent girls with illegally induced abortion in Dar es Salaam: the discrepancy between sexual behaviour and lack of access to contraception
2000 - Reproductive Health Matters, 8(15), p. 52-62
Mots clés : méthodologie; adolescence; adolescent; grossesse non prévue; grossesse non désirée; loi; avortement; programme planning familial; programme; sexualité; contraception; méthode contraceptive; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial; comportement
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This article reports on a study of induced abortion among adolescent girls in Dar es Salaam, Tanzania, who were admitted to a district hospital in Dar es Salaam because of an illegally induced abortion in 1997. In the quantitative part of the study, 197 teenage girls (aged 14-19) were asked for socioeconomic details, contraceptive knowledge/use, age at first intercourse and number of sexual partners. In the qualitative part, 51 teenage girls were interviewed in-depth about their relationship with their partners, sexual behavior, contraceptive use and reasons for non-use, and why they became pregnant. The girls were sexually active at an early age and having sex mainly with men older than themselves. Although most girls were in love with and enjoyed sex with partners, they also entered these relationships to obtain money or gifts in exchange for sex. Most were not using contraception or condoms though they were also at risk of sexually transmitted diseases and HIV. These girls were getting pregnant expecting their boyfriends to marry them, or because they did not think they could become pregnant or failed to use contraception correctly. Most adolescent girls are not aware of the 1994 Tanzanian policy that gave them the right to seek family planning (FP) services and in practice these services are not being provided. There is a need for youth-friendly FP services and to make abortion safe and legal, in order to reduce unwanted pregnancies and abortion-related complications and deaths among adolescent girls. (author's)
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Ouvrage
Kaufman C.E.; Wet T.d.; Stadler J.
Adolescent pregnancy and parenthood in South Africa
2000 - New York (US): Population Council, 41 p. p.
Mots clés : méthodologie; adolescence; adolescent; grossesse adolescente; grossesse; sexualité; grossesse prémaritale; éducation; facteur socio-économique; culture; mariage; état matrimonial; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; facteur économique; nuptialité; état matrimonial; mariage
Pays / Régions : Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : South Africa's total fertility rate is estimated to be one of the lowest in sub-Saharan Africa, less than 3.0 births per woman nationally and declining. At the same time, adolescent childbearing levels remain high; more than 30% of 19-year-old girls are reported to have given birth at least once. Using evidence from focus groups conducted in urban and rural areas in South Africa with young Black women and men, and with the parents of teenage mothers, the authors consider the experience of early parenthood. Specifically, the analysis explores four aspects of teenage childbearing as it relates to key transitions into adulthood: the advent of a pregnancy and the decision to terminate or carry the pregnancy to term; the conditions under which "damages" (a fine for the boy's behavior that also effectively assigns paternity even if no marriage follows) are denied, paid, or refused; the impact of early childbearing on school, work, and marriage; and consequences of premarital childbearing on future relationships, including subsequent fertility. The authors find that in South Africa, in contrast to many other settings, teenage mothers may return to school once they have given birth and that this opportunity is strongly related to a long delay before the birth of a second child. Education is also strongly associated with the valuation of brideprice: girls who are better educated bring a higher price, which may encourage parents to support their daughters' schooling, and perhaps also their return to school following early pregnancy and childbirth. Babies born to teenage parents are extremely vulnerable. Because the baby is usually born premaritally and subsequent marriage between mother and father is uncommon, the support and maintenance of the child are subject to paternal recognition and commitment. The presence of a baby also generally means a lower brideprice for a future marriage; first-born children are sometimes kept secret from prospective grooms to maintain higher brideprice. (author's)
Source : Source : Popline http://db.jhuccp.org/popinform/basic.html - PIP 153081.Article de périodique
Noël M. F.
Approche anthropologique de quelques concepts et conceptions populaires relatifs à la santé maternelle. Représentations et pratiques de la grossesse, de l'accouchement et du post-partum en milieu touareg
2000 - Atelier : Grossesse, Contraception, Avortement, Accouchement en Afrique de l'Ouest, Abidjan (CI) 1999/11/4-7, 1), p. p. 47-60
Mots clés : contraception; méthode contraceptive
Pays / Régions : Mali
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Webb D.
Attitudes to "Kaponya Mafumo": the terminators of pregnancy in urban Zambia
2000 - Health Policy and Planning, 15(2), p. 186-193
Mots clés : méthodologie; ville; résidence; adolescence; adolescent; santé de la reproduction; perception; attitude; sexualité; avortement; grossesse non prévue; grossesse non désirée; décision; population; facteur démographique; jeune; adolescent; âge; santé; psychologie; facteur psychologique; comportement; contraception d'urgence; contraception postcoitale; planning familial; fécondité
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : As part of a larger study of adolescent sexual and reproductive health in urban Zambia, the issue of unwanted pregnancy and abortion was considered through the examination of the perceptions of both adolescents and adults. Young people rank sexual health as their primary health issue, and sexual behavior is integrally linked into other aspects of their lives. Pregnancies were deemed to be a common occurrence amongst the adolescents, with an estimated two-thirds of unwanted pregnancies ending in unsafe abortion. The decision to abort is primarily determined by the reaction of the boyfriend and his willingness to accept paternity and the associated financial implications. Other crucial influences are the desire to stay in school and the stigma attached to unwanted pregnancy. The decision-making process regarding the abortion itself is related to the perceived advantages and disadvantages of various service providers. Around 40% of the respondents stated that in the event of an abortion being carried out, it would be performed either by the girl herself or with the assistance of other non-medical personnel. Less popular but still significant are traditional healers and private doctors. Formal health services tend to be rejected due to their poor perception by young people, centered on the lack of privacy and confidentiality, and the de facto illegal nature of abortion itself. The services of nurses are sought, but outside of the clinic setting. The most popular method of self-induced abortion is overdosing on chloroquine. Other methods involve the use of traditional medicines such as various types of roots, as well as more modern methods such as ingesting washing powder. Recommendations for policy-makers concentrate on the improvement of formal, "youth friendly" health services and the development of appropriate outreach education methods which address specific concerns widely held by young people. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150239.Article de périodique
Anonymous
Attitudes to abortion among adolescents in urban Zambia
2000 - Reproductive Health Matters, 8(16), p. 191
Mots clés : enquête; ville; résidence; adolescence; adolescent; attitude; avortement; étudiant; scolarisation; méthodologie; population; facteur démographique; jeune; adolescent; âge; psychologie; facteur psychologique; comportement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A study in urban Zambia explored attitudes to abortion among adolescents using qualitative data collected in some 100 focus group discussions in five urban districts, and quantitative data from a narrative questionnaire completed by 1100 school children. About 12% of boys aged 10-19 thought they had made a girl pregnant, while 9% of girls aged 10-19 had been pregnant. The main reasons for a girl to decide to abort included the reaction of her boyfriend and his unwillingness to accept paternity, the desire to stay in school and the stigma attached to schoolgirl pregnancy. Traditional healers are the most likely to assist in carrying out abortions, because they are seen to keep confidentiality, not ask probing questions and play the role of spiritually cleansing the girl afterwards. Girls who abort are known as kaponya mafumo (terminators of pregnancies) and there is a belief that they can infect others, one of the main causes of the stigma associated with girls who abort. Private doctors are considered to be "clean" and confidential, but expensive. Self-induced abortion is also common; large dosages of chloroquine is the most frequently mentioned method. These findings show the need for improving youth-friendly health services and developing appropriate and effective outreach methods, including destigmatization of teenage pregnancy. (full text)
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Harrison A.; Montgomery E.T.; Lurie M.; Wilkinson D.
Barriers to implementing South Africa'a Termination of Pregnancy Act in rural KwaZulu Natal
2000 - Health Policy and Planning, 15(4), p. 424-431
Mots clés : méthodologie; rural; résidence; femme; loi; connaissance, attitude; pratique; CAP; attitude; croyance; personnel de santé; service de santé communautaire; offre; service de santé; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement; culture; soin; santé; soin de santé primaire; service de santé
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : South Africa's Termination of Pregnancy Act, the most liberal abortion law in Africa, took effect early in 1997. In spite of the anticipated benefits to women's health, however, public reaction has been mixed. In the country's most populous province, KwaZulu/Natal, opposition is strong and most health care providers have refused to provide the service. This study explored attitudes and beliefs about abortion and the Termination of Pregnancy Act among primary care nurses and community members in a rural district in order to better understand barriers to implementation of the new law. As part of a community survey on women's reproductive health (n = 138), questions on knowledge, attitudes and beliefs about abortion were asked, as well as awareness of the provisions of the Termination of Pregnancy Act. To better understand the perspectives of health care workers, a survey among primary care nurses on duty (n = 25) was also conducted. In-depth interviews were conducted with both nurses and women in the community to further pursue issues raised in the two surveys. Support for the Act was low (11%) among both community members and nurses, and few supported abortion on request (18% and 6%, respectively). Within each group, however, a clear hierarchy of support was observed: a majority of nurses (56%) and community members (58%) supported abortion in the case of rape of incest, or if the continued pregnancy would endanger a woman's health (61% and 56%, respectively), few supported abortion for social or economic reasons. In-depth interviews revealed that abortion is seen as contrary to prevailing community norms; nurses were poorly informed about the Termination of Pregnancy Act and felt confused in their professional responsibilities. Legalization alone cannot ensure implementation of abortion services. In South Africa, extensive media coverage prior to passage of the law ensured almost universal awareness of the Act, but little public education took place at the same time. In spite of general opposition to the law, however, there is an encouraging level of support for abortion in some circumstances. These findings suggest that abortion services can be implemented, even in conservative rural areas, but that a process of information dissemination and community consent prior to implementation is essential. Locating abortion within broader reproductive health services could be an effective way to improve access and acceptability. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 154061.Article de périodique
Anonymous
Burkina Faso: postabortion care. Upgrading postabortion care benefits patients and providers
2000
Pays / Régions : Burkina FasoRésumé : During 1996-98, the Reproductive Health Research Network conducted a study to introduce emergency care for women with complications from miscarriage and abortions. Within this project, physicians, nurses, and midwives at two large hospitals in Ouagadougou and Bobo-Dioulasso were trained to provide postabortion care (PAC), including manual vacuum aspiration (MVA), family planning methods, infection prevention, and communication with patients. Changes in knowledge and behavior were measured through an interview with 330 patients with abortion complications and 78 providers before the intervention, and 456 patients and 41 providers after the intervention. Overall, the study demonstrated that the improved emergency medical care for women with miscarriages and unsafe abortions leads to better patient care, shorter hospital stays, lower costs, and increased contraceptive use. However, when performing MVA, verbal assurance alone from the training staff is inadequate for pain control, but rather local anesthesia is essential. The study also revealed that providers switched to MVA as their preferred treatment for PAC, since MVA lowered costs for both hospital and patients due to shorter hospital stays, less anesthesia, and less staff time.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 152798.Article de périodique
Kafé H.; Brouard N.
Comment ont évolué les grossesses chez les adolescentes depuis 20 ans?
2000 - Population et sociétés, 361(4
Mots clés : enquête; avortement; incidence; prévalence; grossesse adolescente; grossesse; contraception; méthode contraceptive; préservatif; contraception; loi; contraception d'urgence; contraception postcoitale; planning familial; mesure; méthodologie; santé de la reproduction; fécondité; population; facteur démographique; méthodes barrières; contraception
Pays / Régions : France; Europe de l'Ouest; Europe; Pays MéditerranéensRésumé : 25 ans après le vote de la loi Veil du 17 janvier 1975, on discute de nouveau l'interruption volontaire de grossesse (IVG). Parmi les modifications envisagées de la loi figurent l'augmentation du délai légal de recours à l'IVG et l'assouplissement de l'autorisation parentale pour les mineures. Le nombre de grossesses de mineures a diminué de 36% en 17 ans, passant de 20.710 en 1980 à 13.192 en 1997. Cette baisse s'est traduite par une diminution de 60% du nombre des naissances vivantes, mais le nombre annuel d'IVG déclarées chez les mineures a stagné entre 4,9% et 5,9% du nombre total d'IVG. Environ la moitié des naissances et des avortements survenant chez les mineures sont le fait d'adolescentes de 17 ans. La période des années 1960 à 1980 a vu la fin du baby-boom et l'entrée en vigueur de la loi Neuwirth libéralisant la contraception. Globalement, l'évolution de la fécondité des personnes âgées de 12 à 17 ans a connu deux phases. Durant la première phase, au cours des années 1980, la proportion d'adolescentes entamant une grossesse a connu une forte diminution, de 5,4% par an, qui s'est traduite par une baisse de la fréquence des naissances vivantes et de celle des IVG. Ensuite, depuis 1989 et au cours des années 1990, les conceptions sont stabilisées, mais la fréquence des IVG remonte de 2,8% par an, tandis que celle des naissances continue à baisser. L'âge médian des femmes au premier rapport sexuel est resté stable à une valeur de 17 à 18 ans depuis plusieurs années. 51% des femmes qui ont commencé leur vie sexuelle en 1970 n'avaient pas utilisé de contraception au premier rapport sexuel, contre 30% en 1988 et 16% en 1993. 8% des femmes qui ont commencé leur vie sexuelle en 1987 ont utilisé un préservatif, comparé à preès de 90% de telles femmes vers la fin des années 1990. Les auteurs discutent le recours à l'IVG, l'efficacité de la contraception, et le nombre de grossesses chez les adolescentes. Keywords:
Source : Source : Ined - http://www.ined.fr.Article de périodique
Diallo Diabate FS; Traoré M.; Diakité S.; Perrotin F.; Dembélé F.; Diarra I.; Dolo A.
Complications des avortements provoqués illégaux à Bamako (Mali) de décembre 1997 à novembre 1998
2000 - Cahiers d'études et de recherches francophones /santé, 10(4), p. 243-247Résumé : Dans une étude rétrospective descriptive, menée pendant une période de un an dans le service de référence de gynécologie-obstétrique de l'hôpital Gabriel-Touré à Bamako, nous avons analysé 1 081 dossiers de patientes qui se sont présentées dans le service à la suite d'une complication d'avortements spontanés ou provoqués. Nous avons isolé et étudié 189 cas d'avortements provoqués illégaux. Les patientes étaient jeunes (avec un âge moyen de 21,8 ans), d'un bas niveau socio-économique, et n'avaient pour la plupart (71,4 %) aucun enfant vivant. Pour 19,5 % d'entre elles l'âge gestationnel était inférieur à 12 semaines et compris entre 13 et 16 pour 47,6 %. Les manoeuvres abortives ont été pratiquées par des tradipraticiens (3,7 %), des médecins généralistes (9 %), des infirmiers du premier cycle (10,5 %) et des infirmiers d'États et sages-femmes (57,1 %). Dans plus de la moitié des cas (71,4 %) l'avortement a eu lieu au domicile du praticien. Plusieurs méthodes abortives ont été utilisées (curetage, sondage utérin, etc.). Dans 44,4 % des cas, les femmes ont gardé un mutisme complet sur le motif de l'avortement. Les autres ont évoqué des raisons scolaires dans 20,63 % des cas et la crainte des parents dans 13,22 %. Les métrorragies (51,3 %), les hyperthermies (35,4 %) les douleurs (9,52 %) et les troubles neurologiques (3,1 %) ont été les principaux motifs de consultation. Trois types de complications ont été identifiés : les hémorragies (47 %), les complications infectieuses (33,3 %), les intoxications médicamenteuses (4,2 %). La mortalité maternelle a été de 10 %. La prise en charge des patientes a nécessité des traitements chirurgicaux (allant du curetage à l'hystérectomie) et médicaux avec une durée moyenne d'hospitalisation de 10 jours
Source : source cahiers de santé : http://www.john-libbey-eurotext.fr/fr/revues/sante_pub/san/e-docs/00/03/5B/94/resume.md.Article de périodique
Moumouni A.
Conceptions et pratique de l'avortement en pays Songhay-Zarma
2000 - Atelier : Grossesse, Contraception, Avortement, Accouchement en Afrique de l'Ouest, Abidjan (CI) 1999/11/4-7, 1), p. p. 105-110
Pays / Régions : Niger
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Ujah I.A.O.
Contraceptive intentions of women seeking induced abortion in the city of Jos, Nigeria
2000 - Journal of Obstetrics and Gynaecology (Abingdon), 20(2), p. 162-166
Mots clés : contraception; méthode contraceptive
Pays / Régions : NigeriaRésumé : This is a prospective study involving 120 women who requested abortion for an unplanned and unwanted pregnancy. We sought to determine their contraceptive intentions and use. The characteristics of these women revealed that the majority were young, single schoolgirls with 68.5% of them being nulliparous. Over 90% had had their first sexual experience before the age of 20 years. Although, 113 (94%) were aware of the availability of contraceptive services only 70 (62%) of these had ever used a method and the majority of the contraceptive methods selected were ineffective. Although 97 (80.8%) had a positive intention towards post-abortion family planning, only 18 (18.5%) eventually agreed and were offered a method after the termination of pregnancy. The study revealed a high risk group of unplanned and unwanted pregnancy in Jos but low contraceptive use despite the high positive intentions expressed by this cohort of patients. Effective post-abortion contraception counselling should be incoporated into family planning in Nigeria in order that clients who express positive intentions to the use of family planning actually use the method thereby reducing the incidence of repeated induced abortions and its social and medical consequences.
Source : source : Journal of Obstetrics and Gynaecology (Abingdon).Article de périodique
Kyamureku P.T.
Contradictions in human rights and social attitudes: case studies of abortion in Uganda
2000 - Initiatives in Reproductive Health Policy, 3(2), p. 8
Mots clés : grossesse adolescente; grossesse; droit; femme; complication; politique; programme; santé de la reproduction; fécondité; population; facteur démographique; comportement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Africa and in many developing countries, there are many unwritten rules that apply to women. These unwritten rules and regulations, though referred to as culture or tradition, keep women in bondage and in a subservient status to men. Moreover, these regulations limit women's right, health, and development and determine women's access to abortion and other health care. In contrast to these traditional views, many countries, including Uganda, have written constitutions with sections that provide the "Protection and Promotion of Fundamental and Other Human Rights and Freedoms". In this article, two case studies are presented that highlight contradictions between culture and written law and explore questions of human rights as they confront social attitudes in Uganda. Both stories relate the sufferings of two teenagers who became pregnant out of wedlock. It is noted that Ugandan women seeking abortion face severe punishments, which are more often the result of traditions and culture than a requirement of the law. Society and women in particular do not know or understand legal codes and women's rights, thus they act out of ignorance and fear of how society might judge them. Given the increasing effects of these structural adjustments policies in Africa, safe and legal abortion should be an issue of immediate concern.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 153916.Article de périodique
Glynn J.R.; Buve A.; Carael M.; Kahindo M.; Macauley I.B.; Musonda R.M.; Jungmann E.; Tembo F.; Zekeng L.
Decreased fertility among HIV-1-infected women attending antenatal clinics in three African cities
2000 - Jaids. Journal of Acquired Immune Deficiency Syndromes, 25(4), p. 345-352
Mots clés : méthodologie; transition fécondité; VIH; femme; intervalle naissance; avortement; fécondité; population; facteur démographique; maladie; maladie; complication; taux fécondité; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Cameroun; Kenya; Zambie; Afrique Centrale; Afrique Subsaharienne; Afrique; Afrique Francophone; Afrique de l'Est; Afrique AnglophoneRésumé : Population HIV prevalence estimates rely heavily on sentinel surveillance in antenatal clinics (ANCs), but because HIV reduces fertility, these estimates are biased. To aid interpretation of such data, the authors estimated HIV-associated fertility reduction among pregnant women in ANCs in Yaounde (Cameroon), Kisumu (Kenya), and Ndola (Zambia). Data collection followed existing HIV sentinel surveillance procedures as far as possible. HIV prevalence among the women was 5.5% in Yaounde, 30.6% in Kisumu, and 27.3% in Ndola. The birth interval was prolonged in HIV-positive multiparous women compared with HIV-negative multiparous women in all three sites: adjusted hazard ratios of pregnancy were 0.84 (95% CI: 0.62-1.1) in Yaounde, 0.82 (95% CI: 0.70-0.96) in Kisumu, and 0.74 (95% CI: 0.61-0.90) in Ndola, implying estimated reductions in the risk of pregnancy in HIV-positive women of between 16% and 26%. For primiparous women, the interval between sexual debut and birth was longer in HIV-positive women than in HIV-negative women in all sites, although the association was lost in Ndola after adjusting for age and other factors. Consistent results in different study sites help in the development of standard methods for improving ANC-based surveillance estimates of HIV prevalence. These may be easier to devise for multiparous women than for primiparous women. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 154449.Article de périodique
Benagiano G.; Pera A.
Decreasing the need for abortion: challenges and constraints
2000 - International Journal of Gynecology Obstetrics, 70(35-48
Mots clés : revue littérature; avortement; loi; taux; contraception d'urgence; contraception postcoitaleRésumé : Voluntary abortion is the most controversial act in the entire field of medical practice, although today it is a practice that, under different conditions, has been legalized in more than 100 countries, mostly in the developed world. The UN has agreed that in no case should abortion be promoted as a method of family planning and, therefore, it should be utilized only when contraception has failed. Overall, 61% of humanity lives in countries where abortion is legal and widely available; 14% in countries where termination is allowed to protect a woman's health--physical, mental, or both; 21% in countries where it can be performed only to save the mother's life; and 4% in countries where abortion is not permitted at all. Restrictive legislation, per se, does not represent a valid deterrent to prevent abortion, while it may contribute to an increase in morbidity and mortality associated with pregnancy. In addition, because abortion is outlawed, nothing is done to actively reduce the reasons leading to it. Indeed, the countries with the lowest abortion rates are those where, on the one hand, pregnancy termination is legal and, on the other, sex education and contraceptive knowledge are widely spread. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150637.Article de périodique
Solo J.
Easing the pain: Pain management in the treatment of in complete abortion
2000 - Reproductive Health Matters, 8(15), p. 45-51
Mots clés : douleur; complication
Pays / Régions : KenyaRésumé : Although there have been significant improvements in post-abortion care programmes around the world, improvingpain managementhas remained a significant challenge. The introduction of manual vacuum aspiration (MVA) has led to many positive changes in programmes, but the guidelines for pain control have generallybeen vague. Women are often treated with no pain control or in some cases receive too much pain medication. There are many factors contributing to this situation, including: the belief that women who have induced an abortion should be punished, the idea thatpain control is unnecessary, the lack of availability of drugs and inadequate training and/or skills of providers. This paper argues for a greater focus on this important element of quality of care and for clearer guidelines on pain management during treatment of incomplete abortion with MVA. This includes the provision of analgesics immediately before the procedure, counselling and reassurance during the procedure and local anaesthesia when necessary.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Anonymous
Egypt: postabortion care. Expand access to postabortion care
2000
Mots clés : étude; médecin; personnel de santé; soin post-abortum; offre; praticien; prestataire; programme planning familial; étudiant; scolarisation; méthodologie; personnel de santé; soin; santé; planning familial; service de santé; programme
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : A 1997 pilot study sought to institutionalize improved postabortion medical care and counseling procedures in 10 hospitals in Egypt. Conducted by the Egyptian Fertility Care Society, a 5-day training course in manual vacuum aspiration (MVA), infection control, and family planning (FP) counseling was administered to five senior physicians from each hospital. The physicians then supervised 4 months of on-the-job training of doctors and nurses, and introduced a case management protocol. Researchers measured the resulting changes in knowledge and practice by administering surveys before and after the intervention. Overall, findings reveal that after the training, physicians had significant gains in knowledge about short-term complications, adverse health impacts, and the immediate return of fertility following postabortion treatment. There was also a shift from use of dilatation and curettage to use of MVA among physicians. Consequently, a shift from general anesthesia to local anesthesia was noted. Moreover, there was an increase in the proportion of PAC patients stating that the service they received at the hospital was excellent. Several policy implications are cited based on the results.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 154402.Article de périodique
Yaogo M.
Fécondité, contraception et accouchement : quelques matériaux en zone linguistique Moore
2000 - Atelier : Grossesse, Contraception, Avortement, Accouchement en Afrique de l'Ouest, Abidjan (CI) 1999/11/4-7, 1), p. p. 67-74
Mots clés : menstruation; contraception; méthode contraceptive
Pays / Régions : Burkina Faso
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Koster Oyekan W.
Fertility regulation among the Yoruba: an applied participatory research project in Lagos state. Report
2000
Mots clés : focus group; enquête; enquête; fécondité naturelle; contraception; méthode contraceptive; avortement; stérilité; traitement; soin; collecte; méthodologie; étudiant; scolarisation; fécondité; population; facteur démographique; planning familial; contraception d'urgence; contraception postcoitale; santé de la reproduction
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Fertility regulation means all methods and measures intended to influence the natural fertility of a woman. Such methods and measures include infertility treatments, contraception and induced abortion. This paper presents the procedures, experiences, major findings, and recommendations of an applied research project in fertility regulation practices among the Yoruba of Lagos State, Nigeria, from 1997-99. Outlined into eight chapters, chapter 1 is the introduction and gives the rationale for the study and the study objectives. Chapter 2 explains the study methodology and focuses on some of the major activities. Chapter 3 introduces the Yoruba traditional midwives, whose services are highly used in both rural and urban areas. Chapter 4 presents the study findings on the perceptions and treatments of infertility. Chapter 5 deals with prevention of pregnancy and reasons why women are not using any prevention. Chapter 6 tackles the problems related to induced abortion. The discussion and findings on youths are presented in chapter 7. Finally, chapter 8 displays the recommendations for addressing the identified problems. It is hoped that this study will provide more insight into the problems related to fertility regulation and increase the motivation to take action and tackle the problems in an objective, practical way, without prejudices.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 163187.Article de périodique
Anonymous
Guinea: adolescent sexuality in the administrative regions of Faranah, Kankan and N'Zerekore. Results of a narrative studyGuinee: la sexualite des adolescents dans les regions administratives de Faranah, Kankan et N'Zerekore. Resultats d'une recherche narrative
2000
Mots clés : méthodologie; focus group; enquête; jeune; adolescent; adolescence; adolescent; sexualité premaritale; sexualité; attitude; grossesse adolescente; grossesse; avortement; collecte; média; communication; âge; population; facteur démographique; comportement; psychologie; facteur psychologique; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Guinée; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : A key component of PRISM, communication for behavioral change (CBC) encourages populations to adopt and maintain healthy behaviors. Therefore in its action plan, the organization conceived and launched narrative research together with discussion groups exploring the sexual behaviors of adolescents aged 14-19 years in Guinea's Faranah, Kankan, and N'Zérékoré administrative districts. The research's main goal was to identify, through drama, the most prevalent behavioral and sexual relational models among young people. Study data will help in message development and campaign implementation targeting youth. 8 groups of adolescents participated in each region, with each group comprised of 10-12 subjects. There were 4 urban groups and 4 rural groups per region. Study results are presented upon sexual negotiation, first sexual relations, managing pregnancy and abortions, adolescents' sexual behavior following first abortion, STD-related behavior, deciding to carry a second pregnancy to term, young mothers' advice, attitudes on health services and providers, information sources and young people's needs for reproductive health materials, young people's needs, and factors influencing young people's sexuality. Recommendations are offered.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 157347.Article de périodique
Merzouki A.; Ed derfoufi F.; Molero Mesa J.
Hemp (Cannabis sativa L.) and abortion
2000 - Journal of Ethnopharmacology, 73(3), p. 501-503
Mots clés : médicamentRésumé : no abstract
Article de périodique
Yassin K.M.
Incidence and socioeconomic determinants of abortion in rural Upper Egypt
2000 - Public Health, 114(4), p. 269-272
Mots clés : méthodologie; prévalence; mortalité maternelle; rural; résidence; déterminant; morbidité; femme; facteur socio-économique; planning familial; mesure; mortalité; population; facteur démographique; contraception d'urgence; contraception postcoitale; maladie; complication; facteur économique
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : Because of a growing cultural and religious sensitivity and controversy over reproductive health issues, particularly abortion, this area remains relatively unexplored in Egypt. This study was conducted using a participatory approach to determine the morbidity and determinants of abortion in rural Upper Egypt. In all, 1025 women from 6 villages in Upper Egypt were included in the study. Information regarding the incidence of abortion, patterns of health care utilization and risk factors was obtained using a structured interview format. The local dialect was used in formulating questions and they were revised and amended by a panel of local leaders, interviewers and representatives of the study population. Interviewers were local educated (secondary or university level) female volunteers. Information about exposure to 17 risk factors was also collected and statistical analysis was done by estimating the odds ratio and applying a test of statistical significance. Then, a multivariate logistic regression model was applied to control for possible interactions and confounding effects. The results were that 40.6% (n = 416) had aborted at least once; of them, 24.6% (n = 252) had aborted more than once and were designated as recurrent aborters. The lifetime prevalence of recurrent abortion was estimated to be 25% and nearly 21% of pregnancies were aborted. The incidence of abortion was estimated to be 265 per 1000 live birth. Only 21.9% (n = 91) of women received medical care for the last abortion. The vast majority of women (92%, n = 299), who did not seek medical help received help from traditional and domestic sources. These sources are midwife (59.9%, n = 179), relative or neighbor (29.8%, n = 89), and traditional practitioner (10.4%, n = 31). The multivariate analysis revealed that the incidence of abortion is significantly associated with gravidity, consanguinity, and mother occupation, while recurrent abortion is associated with gravidity, consanguinity and woman's age at marriage. In conclusion, the morbidity of abortion is a serious public health problem in Egypt. Because the incidence rate is very high and because safe abortion is limited in Egypt, maternal mortality due to abortion is expected to be underestimated. Promotion of family planning is expected to have a significant impact on the incidence of abortion in Upper Egypt. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 151704.Article de périodique
Ouattara F.
Interactions entre populations et personnels de santé lors des consultations prénatales dans une maternité rurale (Burkina Faso)
2000 - Atelier : Grossesse, Contraception, Avortement, Accouchement en Afrique de l'Ouest, Abidjan (CI) 1999/11/4-7, 1), p. p. 111-125
Pays / Régions : Burkina Faso
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Kiragu J.
Kenyan adolescents at risk
2000 - Initiatives in Reproductive Health Policy, 3(2), p. 11-12
Mots clés : adolescence; adolescent; grossesse adolescente; grossesse; grossesse non prévue; grossesse non désirée; risque; complication; loi; politique; programme; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; comportement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Kenya, population policy is unclear regarding adolescent rights to sexual and reproductive health education and services. Consequently, many Kenyan adolescents who are sexually active, with little information or protection against unwanted pregnancies and sexually transmitted diseases, resort to unsafe abortion and suffer disproportionately from abortion-related mortality. It is also noted that the laws restricting abortion discriminate most against the young and the poor because they have the least access to safe abortion services. Hospital records of women seeking unsafe abortions show that abortion is mainly sought by women who are young, unmarried, either in school or unemployed, and not using any method of contraception. In view of this, it is suggested that access to safe abortion within the existing law regardless of age or social class should be enhanced to reduce the number of abortion-related deaths and the number of cases of incomplete abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 153919.Article de périodique
Koné M.
L'avortement : une pratique contraceptive "sure" en Côte d'Ivoire ?
2000 - Atelier : Grossesse, Contraception, Avortement, Accouchement en Afrique de l'Ouest, Abidjan (CI) 1999/11/4-7, 1), p. p. 95-104
Pays / Régions : Cote d'Ivoire
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Guillaume A.
L'avortement en Afrique: mode de controle des naissances et probleme de sante publique
2000 - Chronique Du Ceped, 37), p. 1-4
Mots clés : avortement; loi; mortalité maternelle; morbidité; femme; planning familial; santé publique; contraception d'urgence; contraception postcoitale; mortalité; population; facteur démographique; maladie; complication; santé
Pays / Régions : AfriqueRésumé : L'avortement provoqué est en Afrique une cause importante de morbidité et de mortalité maternelles. Pour le continent, le taux de mortalité maternelle est estimé à 680 décès pour 100.000 avortements. Les risques liés aux avortements provoqués en Afrique sont dus au caractère illégal de l'acte dans beaucoup de pays, aux problèmes d'accès aux services habilités, et au manque de prise en charge sanitaire et sociale des femmes après un avortement. Dans les trois centres hospitaliers universitaires d'Abidjan entre 1989 et 1992, 70% des décès maternels étaient consécutifs à des avortements provoqués survenus à domicile ou dans de mauvaises conditions. En dépit d'un cadre législatif et réglementaire souvent restrictif et malgré des conditions d'intervention médiocre au plan sanitaire, le recours à l'avortement semble se développer, surtout chez les jeunes et davantage parmi les jeunes femmes scolarisées ou souhaitant poursuivre leurs études. Les ratios d'avortement sont toujours plus élevés en zone urbaine qu'en milieu rural. Une étude a été conduite en Côte d'Ivoire auprès des consultantes de quatre centres de santé d'Abidjan afin de mieux cerner les motifs d'avortement et les méthodes employées. L'auteur explique l'importance du phénomène de l'avortement en Côte d'Ivoire, les méthodes abortives utilisées, les principaux motifs d'avortement, et la contraception et l'avortement. Le recours à l'avortement provoqué en Afrique est souvent une réponse aux besoins non satisfaits de planification familiale. Un meilleur accès à des programmes orientés surtout vers les adolescentes et les jeunes femmes réduirait l'incidence de l'avortement provoqué.
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Berer M.
Making abortions safe : a matter of good public health policy and practise
2000 - Bulletin of World Health Organisation, 78 (5)(Special theme - reproductive health), p. 580-592
Mots clés : revue littérature; mortalité maternelle; morbidité; avortement; risque; santé publique; politique; mortalité; population; facteur démographique; maladie; complication; contraception d'urgence; contraception postcoitale; planning familial; santéRésumé : Globally, abortion mortality accounts for at least 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. This article examines the changes in policy and health service provision required to make abortions safe. It is based on a wide-ranging review of published and unpublished sources. In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost, and counseling issues. The transition from unsafe to safe abortions demands the following: changes at national policy level; abortion training for service providers and the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. Public awareness that abortion services are available is a crucial element of this transition, particularly among adolescent and single women, who tend to have less access to reproductive health services generally. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 151048.Article de périodique
Ghorab M.N.
Misoprostol; intracervical versus intravaginal routes: a comparative study in induction of midtrimester abortion
2000 - Egyptian Society of Obstetrics and Gynecology, 26(10-12), p. 959-965
Mots clés : méthodologie; médicament; Misoprostol; méthode; risque; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé publique; santé
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : The objective was to compare the efficacy and safety of intracervical misoprostol compared with intravaginal misoprostol in induction of mid-trimester abortion. The study was carried out at the Department of Obstetrics and Gynecology at El-Galaa Teaching Hospital. The sample included 54 pregnant women between 16 and 24 weeks of gestation with indicated therapeutic abortion. They were randomly assigned to receive either intravaginal (group I, n = 30) or intracervical (group II, n = 24) misoprostol. 200 mcg misoprostol was administered intravaginally in group II and 50 mcg was administered intracervically in group II. The dose was repeated every 6 hours according to the response, and results were compared. There was a significant difference between group I and II as regards the rate of successful abortion within 24 hours (100% in group II vs. 80% in group I). The median induction-to- delivery interval was significantly shorter in group II (9.6 hours) vs. group I (13.7 hours), with P < 0.05. The median dose of misoprostol was 400 mcg (range, 200-600 mcg) in group I, compared to 75 mcg in group II (range, 50-150 mcg). Also, this study showed a significant higher incidence of side effects in group I (35%) vs. group II (18%), with P < 0.05. The author concludes that intracervical administration of misoprostol is a safe and more effective alternative for termination of mid- trimester pregnancy. (author's, modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 162286.Article de périodique
Anonymous
New Women of the World publication features Francophone Africa
2000 - Reproductive Freedom News, 9(6), p. 2
Mots clés : femme; loi; droit; santé de la reproduction; politique; programme; facteur politique; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé; facteur socio-économique; facteur économique
Pays / Régions : Afrique Francophone; AfriqueRésumé : This article presents the publication Women of the World--Francophone Africa: Laws and Policies Affecting their Reproductive Lives, by Codou Bop, a Senegalese women's rights activist. This book contains a comprehensive review of the reproductive health and rights of women in Benin, Burkina Faso, Cameroon, Cote d'Ivoire, Mali, Senegal, and Chad. It provides practical and legal guidelines for rights advocates and identifies problem issues in the region. Each country was examined in terms of its political framework, sources for governing laws, customary laws and health, population and family planning policies. Across the seven nations, similar problems in restrictive abortion laws, high maternal mortality rates, high HIV/AIDS prevalence rates, low contraceptive use and the continuation of harmful traditional practices were noted. Likewise, legal status of women in the context of their right to be free from discrimination and issues affecting adolescents were examined. During the launching of the book, representatives from the featured countries were able to discuss strategies for revising laws and adopting better policies to protect the rights and welfare of women.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150024.Article de périodique
Ikpeze O.C.
Pattern of morbidity and mortality following illegal termination of pregnancy at Nnewi, Nigeria
2000 - Journal of Obstetrics and Gynaecology (Abingdon). 20(1), p. 55-57
Pays / Régions : NigeriaRésumé : Seventeen women were treated for complications of illegal termination of pregnancy over a 2-year period, January 1996 to December 1997. Important characteristics of the women include a mean age of 21 years (mode 18 years) and being unmarried (100%, n=17), nulliparous (94%, n=16) and unemployed (76%, n=13). There was a tendency towards late termination as 50% of women had a termination after 13 weeks. Serious complications were cervical laceration, pelvic abscess/peritonitis, ruptured uterus, transection of the sigmoid colon and ileal/jejunal lacerations. The mortality rate was 6% (n=1). Most of the terminations were performed through instrumental cervical dilatation without prior medical or hydrophilic treatment. This study shows that illegal abortions are still commonly performed in Nigeria with an unacceptably high incidence of morbidity and mortality. Modemisation of abortion laws, wider contraceptive usage, adoption of modern methods of termination of pregnancy (RU 486 and prostaglandin E1 analogues) and prophylactic antibiotics are recommended in order to reduce the problems of unsafe abortion in Nigeria and other developing countries.
Source : source : Journal of Obstetrics and Gynaecology (Abingdon).Article de périodique
Lema V.M.; Mpanga V.
Post-abortion contraceptive acceptability in Blantyre, Malawi
2000 - East African Medical Journal, 77(9), p. 488-493
Mots clés : méthodologie; enquête; soin post-abortum; contraception; méthode contraceptive; femme; planning familial; counseling; santé de la reproduction; clinique; hôpital; service de santé; programme
Pays / Régions : Malawi; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This cross-sectional pilot study aimed to assess the acceptability of contraceptive counseling and services by 464 post-abortion patients being treated at the gynecological ward of the Queen Elizabeth Central Hospital in Blantyre, Malawi. The socio-demographic and reproductive profiles of the respondents were obtained, as well as information on previous contraceptive use, whether index pregnancy was wanted or not, and whether abortion was induced or not. Results showed that mean age and parity of the respondents were 24 (SD 6.1) and 1.5 (SD 1.9), respectively. Index pregnancy was reported as unintended by 45.3%, and 17.2% said they had an unsafe abortion; 373 (80.4%) accepted contraception; and the main contraceptive methods used were combined oral pills, injectables, and condoms. There was no relationship between acceptance and one's age, marital status, or parity. Overall, this study indicated that post-abortion contraception is acceptable with proper planning and will provide additional contraceptive service opportunity. It is recommended that post-abortion contraception be integrated into emergency post-abortion care..
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 158229.Article de périodique
Blé M.Y.
Représentations populaires relatives à la grossesse et à l'avortement provoqué en milieu rural ivoirien : le cas des Bété de Guiberoua
2000 - Atelier : Grossesse, Contraception, Avortement, Accouchement en Afrique de l'Ouest, Abidjan (CI) 1999/11/4-7, 1), p. p. 27-34
Pays / Régions : Cote d'Ivoire
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Nyirarukundo M.G.
Reproductive rights in Senegal: limited by social expectations
2000 - Initiatives in Reproductive Health Policy, 3(2), p. 7
Mots clés : droit; femme; complication; culture; service de santé; programme; contraception d'urgence; contraception postcoitale; planning familial; soin; santé
Pays / Régions : Sénégal; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : In Senegal, women's social behavior, notably in the areas of health and sexuality, is influenced by their religion--Islam. It is shown that women rarely have a choice concerning reproductive matters that affect them, particularly those related to unwanted pregnancy and abortion. Women who abort under other conditions risk criminal imprisonment, rejection by society and medical complications due to infections, which can lead to death or sterility. It is noted that women's rights and abilities to negotiate their health and sexuality are tied to a number of factors, including poverty, literacy, gender relations, and access to health services. In view of this, it is suggested that increasing women's economic capacity permits them to improve their social position as well. In addition, improving health coverage, training birth attendants, structuring a healthier environment, making information available, and raising awareness are important elements to improve health of the women.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 153915.Article de périodique
El Dawla A.S.
Reproductive rights of Egyptian women: Issues for Debate
2000 - Reproductive Health Matters, 8(16), p. 45-54
Mots clés : droit
Pays / Régions : EgypteRésumé : Because the definitions of reproductive health and reproductive rights are so broad, it has been possible in Egypt and elsewhere for one or other issue on the reproductive health agenda to be prioritised to the detriment or exclusion of others, and a comprehensive approach avoided. Reproductive health and rights language was introduced in Egypt around the time of the International Conference on Population and Development in Cairo in 1994. From the moment these concepts were translated into Arabic, activists, scholars and women themselves discussed and debated their meanings and questioned whetherEgyptian culture permitted a rights approach of this kind and whether reproductive rights were actually perceived as such by Egyptian women. This paper discusses the language of reproductive rights in relation to cultural specificity in the Egyptian context Egyptian women's perceptions of reproductive rights, the role of tradition and religion, and the ways in which reproductive rights are taken up under Egyptian law. It analyses some of the arguments used against reproductive rights on these grounds.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Rasch V.; Muhammad H.; Urassa E.; Bergstrom S.
Self-reports of induced abortion: an empathetic setting can improve the quality of data
2000 - American Journal of Public Health, 90(7), p. 1141-1144
Mots clés : méthodologie; enquête; complication; hôpital; hospitalisation; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé; analyse
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This study estimated the proportion of incomplete abortions that are induced in hospital-based settings in Tanzania. A cross-sectional questionnaire study was conducted in two phases at three hospitals in Tanzania. Phase 1 included 302 patients with a diagnosis of incomplete abortion, and phase 2 included 823 such patients. In phase 1, in which cases were classified by clinical criteria and information from the patient, 3.9-16.1% of the cases were classified as induced abortion. In phase 2, in which the structured interview was changed to an empathetic dialogue and previously used clinical criteria were omitted, 30.9-60.0% of the cases were classified as induced abortion. An empathetic dialogue improves the quality of data collected among women with induced abortion. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150205.Article de périodique
Anonymous
Senegal: postabortion care. Train more providers in postabortion care
2000
Mots clés : programme; personnel de santé; demande; soin post-abortum; avortement spontané; complication; traitement; soin; counseling; soin; santé; contraception d'urgence; contraception postcoitale; planning familial; programme planning familial; éducation; complication grossesse; maladie; complication; clinique; hôpital; service de santé
Pays / Régions : Sénégal; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : In 1997, the Center for Training and Research in Reproductive Health and the Obstetrics and Gynecology Clinic at Le Dantec University Teaching Hospital in Dakar, Senegal, introduced new clinical techniques to improve emergency treatment for women with complications from miscarriage and abortion. Under this project, physicians, nurses, and midwives at three teaching hospitals received training in manual vacuum aspiration, family planning, and counseling. The impact of the training was measured through interview with 320 women receiving emergency treatment and 204 providers before the intervention and 543 patients and 175 providers after the intervention. Information on service delivery costs was also collected. In general, improving postabortion care (PAC) services benefits patients and reduces costs. In particular, providing PAC services resulted in shorter hospital stays, decreased patients costs, better communication between providers and patients, and increased acceptance of contraceptive use by women treated for abortion or miscarriage. Certain policy implications are discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 152799.Article de périodique
Anonymous
Sex and youth -- misperceptions and risks
2000 - Progress in Reproductive Health Research, 53), p. 1
Mots clés : enquête; adolescence; adolescent; jeune; adolescent; grossesse non prévue; grossesse non désirée; sexualité; risque; contraception; méthode contraceptive; avortement; étudiant; scolarisation; méthodologie; âge; population; facteur démographique; santé de la reproduction; fécondité; comportement; planning familial; contraception d'urgence; contraception postcoitale
Pays / Régions : Afrique; Asie; Amérique LatineRésumé : Since the late 1980s, a number of research initiatives on sexual and reproductive health care has been supported by the UN Development Program/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction. The studies include the dynamics of contraceptive use, the determinants and consequences of induced abortion, sexual behavior, the role of men, and the needs and perceptions of young people. This paper reviews the findings of case studies involving adolescents and young people in Africa, Asia, and Latin America. Overall, the studies suggest that in every sociocultural setting, sexual activity begins during adolescence, and much of this activity is risky: contraceptive use is erratic, and unwanted pregnancy and unsafe abortions are observed. In addition, there exist wide gender-based differences in sexual conduct, and in the ability to negotiate sexual activity and contraceptive use. Despite this situation, relatively few young people think they are at risk of disease or unwanted pregnancy, awareness of safe sex seems superficial, and misinformation concerning the risks and consequences of unsafe sex is widespread. Implications for policies and programs are discussed, and research gaps are highlighted. Several recommendations are offered. A more in-depth behavioral research on the perspectives and experiences of youth in different settings is suggested.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 152212.Article de périodique
Okpani A.O.; Okpani J.U.
Sexual activity and contraceptive use among female adolescents--a report from Port Harcourt, Nigeria
2000 - African Journal of Reproductive Health, 4(1), p. 40-47
Mots clés : adolescence; adolescent; adulte; âge; contraception; méthode contraceptive; connaissance; homme; grossesse; ville; résidence
Pays / Régions : NigeriaRésumé : Seven hundred and sixty-eight randomly selected single senior secondary school girls from Port Harcourt (mean age 16.32 years) were surveyed on aspects of sexual activity and contraceptive use. Two hundred and ten pregnancies (24 deliveries and 186 induced abortions) had occurred in 142 out of 605 girls (78.8%) who admitted being sexually exposed. The mean, modal and youngest ages of initiation into sexual activity were 15.04, 15 and 12 years respectively. At the time of the survey, 190 girls (24.7%) were sexually active and 74.2% of their male consorts were older working men, suggesting financial gains as a motive for the girls' sexual activity. Other findings were high awareness (72.4%) of the relationship between sexual activity and sexually transmitted diseases; a rather low level (56%) of knowledge of effective contraceptive methods, and limitation of contraceptive method use by sexually active girls, largely to the rhythm and withdrawal methods. Exposure to multiple sexual partners and a high level of parental approval of subjects' use of contraception were also present. In view of our findings, it is suggested that active efforts to promote sexuality education and contraceptive use should be intensified among Nigerian adolescents.
Source : Source : African Journal of Reproductive Health.Article de périodique
Agyei W.K.A.; Biritwum R.B.; Ashitey A.G.; Hill R.B.
Sexual behaviour and contraception among unmarried adolescents and young adults in Greater Accra and Eastern regions of Ghana
2000 - Journal of Biosocial Science, 32(4), p. 495-512
Mots clés : contraception; méthode contraceptive; sexualité; adolescence; adolescent
Pays / Régions : GhanaRésumé : A fertility survey of unmarried adolescents and young adults (953 males and 829 females) in Greater Accra and Eastern regions of Ghana revealed that a substantial proportion of the respondents were sexually experienced. Overall, 66.8% of the males and 78.4% of the females were sexually experienced. The mean ages (+- SD) of the males and females were 15.5 +- 2.5 and 16.2 +- 2.0 years, respectively. Most respondents claimed to have received adequate information on reproductive health and sexually transmitted diseases (STDs), including AIDS. However, 20% and 30% of the respondents in peri-urban and rural areas, respectively, did not know that a girl could get pregnant the first time she has sexual intercourse. The incidence of pregnancy among the unmarried female respondents was relatively high (37%), and was higher in urban than in rural areas. Approximately 47% of those who had ever been pregnant reported that they had had an abortion. Levels of contraceptive awareness were high (98.2% among males and 95.5% among females) but many still engaged in unprotected sexual relations. The most commonly used methods were the condom and the pill. The main reasons given for non-use were that they did not think about contraception, were concerned about the safety of contraceptives, and partner objection. These findings point to the need for targeting of unmarried adolescents and young adults with information on reproductive health and family planning to increase their awareness of the risks of pregnancy, STDs and HIV infection. (© 2000 Cambridge University Press)
Source : source : journal of biosocial science http://titles.cambridge.org/journals/journal_catalogue.asp?historylinks=ALPHAmnemonic=JBS.Article de périodique
Gmeiner A.C.; Van Wyk S.; Poggenpoel M.; Myburgh C.P.
Support for nurses directly involved with women who chose to terminate a pregnancy
2000 - Curationis, 23(1), p. 70-78
Mots clés : avortement
Pays / Régions : Afrique du Sud
Source : source :Curationis.Article de périodique
Bugalho A.; Mocumbi S.; Faundes A.; David E.
Termination of pregnancies of <6 weeks gestation with a single dose of 800 micrograms of vaginal misoprostol
2000 - Contraception, 61(1), p. 47-50
Mots clés : méthodologie; Misoprostol; méthode; médicament; méthode; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : This study evaluated the effectiveness of a single dose of the abortifacient effect of vaginal misoprostol followed by prolonged observation. Women with 42 or fewer days of amenorrhea, pregnancy confirmed by ultrasound, and approved request for termination received 800 mcg of vaginal misoprostol once and were observed for 1 week. The gestational sac was measured before misoprostol administration, and 24 hours and 7 days afterward. Women reported bleeding, expulsion of sac, and other complaints. After 1 week, those who had not aborted received a second dose of 800 mcg. Those who had not aborted by 24 hours later were treated by vacuum aspiration of the endometrial cavity. 24 hours after treatment, 71.8% had aborted, and 87.1% aborted 3 days after treatment. After the second dose, 7 days later, the cumulative abortion rate reached 92.1%. None of the subjects who aborted required curettage or vacuum aspiration. The main complaints were pain (84.5%), nausea (21.4%), and headache (17.5%). No clinical differences between responders and nonresponders was found. Vaginal misoprostol, 800 mcg, is effective in inducing early termination of pregnancy, and there is no need for an additional dose within 72 hours after the first administration of misoprostol. (author's)
Source : Abstract from CONTRACEPTION, V61(1): 47-50, Bugalho A et al: "Termination of pregnancies of <6 weeks gestation with a single dose of 800 micrograms of vaginal misoprostol" © 2000 Elsevier Inc.Article de périodique
Engelbrecht M.C.; Pelser A.J.; Ngwena C.; van Rensburg H.C.
The implementation of the Choice on Termination of Pregnancy Act: some empirical findings
2000 - Curationis, 23(2), p. 4-14
Mots clés : adolescence; adolescent; adulte; âge; personnel de santé; service de santé; connaissance
Pays / Régions : Afrique du Sud
Source : source :Curationis.Article de périodique
Bongaarts J.; Westoff C.F.
The potential role of contraception in reducing abortion
2000 - Studies in Family Planning., 313( 3), p. 193-202.
Mots clés : méthodologie; prévalence contraceptive; contraception; méthode contraceptive; avortement; planning familial; contraception d'urgence; contraception postcoitaleRésumé : This study examines the potential role of further increases in contraceptive prevalence and effectiveness in reducing abortion rates. The model used in this analysis links the abortion rate to its direct determinants, including couples' reproductive preferences, the prevalence and effectiveness of contraceptive practice to implement these preferences, and the probability of undergoing an abortion to avoid an unintended birth when a contraceptive fails or is not used. An assessment of the tradeoff between contraception and abortion yields estimates of the decline in the total abortion rate that would result from an illustrative increase of 10 percentage points in prevalence. This effect varies among societies, primarily because the tendency to obtain an abortion after an unintended pregnancy varies. For example, in a population with an abortion probability of 0.5, a 10 percentage-point increase in prevalence would avert approximately 0.45 abortions per woman, assuming contraception is 95% effective. If all unintended pregnancies were aborted, this effect would be three times larger. Eliminating all unintended pregnancies and subsequent abortions would require a rise in contraceptive prevalence to the level at which all fecund women who do not wish to become pregnant practice contraception that is 100% effective. A procedure is provided for estimating this "perfect" level of contraceptive prevalence. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 152004.Article de périodique
Rasch V.; Muhammad H.; Urassa E.; Bergstrom S.
The problem of illegally induced abortion: results from a hospital-based study conducted at district level in Dar es Salaam
2000 - Tropical Medicine and International Health, 5(7), p. 495-502
Mots clés : méthodologie; enquête; loi; avortement; avortement spontané; fausse couche; facteur socio-économique; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; facteur économique
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Illegal abortion is known to be a major contributor to maternal mortality. The objective of the study was firstly to identify women with illegally induced abortion (IA), and to compare them with women admitted with a spontaneous abortion (SA) or receiving antenatal care (AC), and secondly to describe the circumstances which characterize the abortion. The population of this cross-sectional questionnaire study comprised patients from Temeke District Hospital, Dar es Salaam, Tanzania. After an in-depth confidential interview, 603 women with incomplete abortion were divided into two groups: 362 women with IA and 241 with SA. They were compared with 307 AC women. IA women were significantly younger, more often better educated, unmarried, nulliparous and students than AC women. Regarding civil status, educational level, proportion of nulliparas and students, SA patients were similar to AC women. These results lend support to the assumption that the in-depth confidential interview made it possible to distinguish IA women from SA women. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 151414.Article de périodique
Varkey S.J.; Fonn S.; Ketlhapile M.
The role of advocacy in implementing the South African abortion law
2000 - Reproductive Health Matters, 8(16), p. 103-111
Mots clés : méthodologie; loi; offre; praticien; prestataire; droit; femme; grossesse non prévue; grossesse non désirée; sexualité; communication; avortement; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé; santé de la reproduction; fécondité; population; facteur démographique; psychologie; facteur psychologique; comportement
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In order to translate the abortion law in South Africa into services that ensure equity of access and women's right to control their bodies, interventions are needed to change judgmental views on abortion. This paper describes formative research conducted in the Northern Cape Province among 436 community members, 29 women seeking an abortion and 80 health service providers, to develop appropriate interventions to these ends. Based on the findings, two interventions were developed. These interventions appeared to substantially influence personal views by getting people to make a connection between the need for abortion services and the circumstances in which unwanted pregnancies occur. There was a shift towards greater support for women's right to choose in relation to abortion among women community members, though not among men, who resisted this right for married women. Amongst providers (almost all women) there was an increase in willingness to support service provision and to support staff working in abortion services. These tools could be used in sexuality education in schools and in nurse-midwifery/medical training, to complement current advocacy initiatives taking place at policy and program levels in South Africa, to help to reduce the public health problem of unsafe abortion. (author's)
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Desgrées du Loû A.; Msellati P.; Viho I.; Welffens Ekra C.
The use of induced abortion in Abidjan : a possible cause of fertility decline?
2000 - Population : an english selection, INED, 12(197-214
Mots clés : contraception; méthode contraceptive; transition fécondité
Pays / Régions : Cote d'IvoireRésumé : Signs exist of the beginning of a fertility decline in Africa. Although it is a relatively recent phenomenon in sub-Saharan Africa, women's mean average total fertility has been falling since the end of the 1980s in many countries where reliable data are available. In Cote d'Ivoire, most such decline occurred from the 1980s, with an average reduction in fertility of 1.5 children per woman between the Ivoirian Fertility Study and the Demographic and Health Survey of 1994. Observed fertility decline is even more marked in urban areas. Considerable fertility decline was observed among the youngest reproductive-aged people in the country. It is, however, curious to observe fertility decline across all age groups in Cote d'Ivoire in the prevailing context of lower age at first birth and low contraceptive prevalence levels. In 1994, Only 6% of women in the country overall and 18% of sexually active women not in union were using modern contraception. Among 1201 pregnant women surveyed in 1997, of whom 204 were primigestes, there were approximately 2828 pregnancies over the course of approximately 20 years, of which 474 ended in induced abortion. Therefore, despite the illegal status of induced abortion in Cote d'Ivoire, these study findings show the current incidence of induced abortion in Abidjan to be comparable to that in the more developed countries where such abortion is legal. Public health programs in Cote d'Ivoire must not ignore the practice of induced abortion in the country.
Source : source Population : http://www.ined.fr/publications/population/index.html.Article de périodique
Lutalo T.; Kidugavu M.; Wawer M.J.; Serwadda D.; Zabin L.S.; Gray R.H.
Trends and determinants of contraceptive use in Rakai District, Uganda, 1995-98
2000 - Studies in Family Planning, 31(3), p. 217-227
Mots clés : méthodologie; enquête; rural; résidence; contraception; méthode contraceptive; planning familial; sexualité; préservatif; contraception; étudiant; scolarisation; population; facteur démographique; méthodes barrières; contraception
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District, Uganda. Over a period of 30 months, women's use of modern contraceptives increased significantly from 11% to 20%. Male condom use increased from 10% to 17%. The prevalence of pregnancy among sexually active women aged 15-49 declined significantly from 15% to 13%. Women practicing family planning from pregnancy prevention were predominantly in the 20-39 age group, married, better educated, and had higher parity than others, whereas women or men adopting condoms were predominantly young, unmarried, and better educated. Condom use was particularly high among individuals reporting multiple sexual partners or extramarital relationships. Contraceptive use was higher among women who desired fewer children, among those who wished to space or terminate childbearing, and among women with previous experience of unwanted births or abortions. Self-perception of HIV risk increased condom use, but HIV testing and counseling had only modest effects. Contraception for pregnancy prevention and that for HIV/STD prophylaxis are complementary. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 152009.Article de périodique
Pierce E.; Settergren S.
Unsafe abortion and postabortion care in Zimbabwe: community perspectives
2000 - Policy Matters, 1), p. 1-4
Mots clés : communauté; complication; soin post-abortum; connaissance, attitude; pratique; CAP; résidence; population; facteur géographique; contraception d'urgence; contraception postcoitale; planning familial; programme planning familial
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This research aims to explore the role of communities in the prevention of unsafe abortion and provision of client-oriented postabortion care (PAC) in Zimbabwe. The researchers employed methods of social theater to promote community dialogue and document community perspectives. The first phase of this project sensitizes the communities to the problems of unsafe abortion and motivates community action, which is then followed by measuring the impact of the social theater intervention in mobilizing community action. After the presentation, key interviews with community members yielded the following information: prevalent community knowledge about unsafe abortion; common abortion sources and methods; and health-seeking behavior for abortion complications and PAC services. With respondents acknowledgement that abortion and unwanted pregnancy have negative effects on the community, members cited several recommendations to encourage better community dialogue and mobilization to prevent and eventually eradicate unsafe abortion, and provide PAC services. Likewise, policy implications of these findings suggest three key strategies: 1) listening, 2) educating, and 3) establishing partnership with the community.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 149960.Article de périodique
Mashalli A.E.
Unsafe abortion: a challenge to safe reproductive health in Egypt
2000 - Egyptian Society of Obstetrics and Gynecology, 26(7-9), p. 725-737Résumé : During January 1998 to December 1999, a prospective, descriptive, cross-sectional, hospital-based study was conducted in an emergency obstetric unit in Mansoura University Hospital, Egypt. It aimed to evaluate the magnitude of the problem of unsafe abortion and propose a strategy for the prevention of the co- morbidity and mortality of unsafe abortion. 3307 postabortion cases were enrolled in the study. Overall, findings revealed that induced abortion cases represented one in every eight emergency obstetric admissions. Based on women's own history, interview and clinical findings, the common features of these abortions were that they were clandestine and illicit, unhygienic, and conducted by unqualified individuals. This has led to serious abortion complications and statistically significant higher risks of short- term co-morbidity and mortality. To properly address abortion- related complications, the integration of high-quality services in all obstetric service units is recommended.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 162277.Article de périodique
Althaus F.A.
Work in progress: the expansion of access to abortion services in South Africa following legalization
2000 - International Family Planning Perspectives, 26(2), p. 84-86
Mots clés : enquête; loi; santé; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In South Africa, liberalization of abortion became possible only after the 1994 elections that ended apartheid. The law in effect at that time allowed abortion only when a pregnancy could seriously threaten a woman's life or her physical or mental health; could end in the birth of a severely handicapped child; or resulted from rape, incest or other unlawful intercourse. In 1996, the Choice on Termination of Pregnancy Act was passed; it made access to legal abortion an integral part of the national health plan drafted during the 1994 elections. Since then, the South African abortion law has been made liberal. However, implementation of abortion services presented numerous challenges. These include access, lack of trained health practitioners to perform pregnancy terminations, lack of public education and moral issues. In view of such, several initiatives were conducted; values clarification workshops were directed and training programs were initiated throughout the country. Although, the South African public health system has achieved a great deal in 3 years since abortion was legalized, several problems still need to be addressed.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2608400.html.
1998Article de périodique
Becker B.
78,000 women die each year from unsafe abortions worldwide. It is estimated that there are 20 million unsafe abortions per year on a global basis
1999 - Reproductive Freedom News, 8(3), p. 1, 5
Mots clés : loi; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique du Sud; Pologne; Chili; Népal; El Salvador; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique Anglophone; Europe de l'Est; Europe; Amérique du Sud; Amérique; Amérique Latine; Asie du Sud; Asie; Amérique centrale; Amérique du NordRésumé : At February's Cairo+5 proceedings at the Hague, the Center for Reproductive Law and Policy (CRLP) called a press conference to discuss changes in abortion laws around the world since the International Conference on Population and Development in Cairo in 1994. According to the director of CRLP's International Program, 9 countries have modified their abortion laws since Cairo. Of those, 7 liberalized their laws, while Poland and El Salvador further restricted legislation. The CRLP supports the liberalization of abortion laws for all women in all countries. Abortion law has been liberalized in South Africa since Cairo, with the enactment in 1997 of the Termination of Pregnancy Act. In contrast, however, anti-choice groups in Poland successfully challenged the legality of abortion in 1996 by declaring it against the Polish Constitution. Abortion is prohibited in Chile in all circumstances, even to save the life of the woman. However, despite the illegality of abortion in that country, half of all pregnancies in Chile end in abortion. Unsafe abortion contributes to the 50% maternal mortality rate in Nepal. Abortion in the country is punishable by a 20-year prison sentence, regardless of the age of the woman.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 140297.Article de périodique
Goyaux N.; Yace Soumah F.; Welffens Ekra C.; Thonneau P.
Abortion complications in Abidjan (Ivory Coast)
1999 - Contraception., 60(2), p. 107-109
Mots clés : méthodologie; enquête; mortalité maternelle; complication; morbidité; femme; santé; étudiant; scolarisation; mortalité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; maladie; complication
Pays / Régions : Cote d'Ivoire; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : A retrospective study was undertaken to assess the effect of various abortion practices on maternal health. The study was based on the medical files of all 472 women admitted to an obstetrics department in Abidjan, Ivory Coast, for abortion complications during a 3-year period (1993-95). The medical records of the sociodemographic and medical characteristics of women upon admission were assessed. Results demonstrated that the introduction of plant stems into the uterus was the most frequently used abortion method (31%), followed by herbal pessaries (23%) and plant infusions (20%). About 17 maternal deaths were registered, giving a maternal mortality rate of 3.6%. A high number of previous pregnancies and the ingestion of plants to provoke abortion were the factors associated with the highest risk of maternal death. Furthermore, complications resulting from local abortion methods accounted for a high proportion of maternal deaths. From the results, it was found that the potential lethal risks associated with local abortion methods were high. These results suggest that more rapid and efficient hospitalization in abortion cases and greater access to family planning would reduce the rate of maternal mortality in Ivory Coast.
Source : Abstract from CONTRACEPTION, V60(2): 107-109, Goyaux N et al: "Abortion complications in Abidjan (Ivory Coast) © 1999 Elsevier Inc.Ouvrage
Mundigo A.I.; Indriso C.
Abortion in the developing world
1999 - New Dehli: OMS, 499 p.Résumé : This book presents 22 studies on abortion in different countries of the world. Using qualitative data, the contributors explore the motivations, the decision processes and the socioeconomic circumstances that cause women to opt for abortion. They also discuss situations where the practice is legal and discuss various issues including method failure, motivation, poor use of contraception and quality of care. Also included in the book are viewpoints of married, unmarried, and adolescent abortion seekers and of service providers. The overall objective of this collection is to explore a fundamental question: why do women opt for abortion to regulate fertility, even in contexts where family planning is widely available? To answer this question, the volume has been organized around the following major themes: the relationship between abortion and contraception; the quality of pre- and post-abortion care; and attitudes toward abortion. The last part of the book draws lessons from the studies regarding both methodology and policy.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156337.Article de périodique
Dehne K.L.
Abortion in the north of Burkina Faso
1999 - African Journal of Reproductive Health, 3(2), p. 40-50
Mots clés : méthodologie; enquête; femme; avortement; connaissance, attitude; pratique; CAP; méthode; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; médicament
Pays / Régions : Burkina Faso; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : An investigation was conducted on the knowledge and practice of induced abortion in remote, rural, ethnically heterogeneous societies in Burkina Faso. Using clinical findings, key informant interviews, and a sample survey, 320 married women in 21 villages were studied. Results revealed that detailed knowledge of abortion and abortive plants is common among both the Fulani and the Gurmance. Among the respondents, 129 (56%) admitted knowing about abortions being carried out in their villages. Higher response rates and abortion knowledge were common among younger women and those belonging to the Islamic Hamallist and Wahabiya sectors. The best known abortifacient plant in the area was Securidaca longepedunculata, which contains both ergot-alkaloids and several poisonous substances; its adverse effects include heavy vaginal bleeding, abdominal pain, diarrhea, vomiting, and sometimes death. This paper suggests the need for a rapid introduction of safer birth control methods in the region.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147699.Article de périodique
Kasule J.; Mbizvo M.T.; Gupta V.
Abortion: attitudes and perceptions of health professionals in Zimbabwe
1999 - Cent Afr J Med, 45(9), p. 239-244.
Mots clés : loi
Pays / Régions : ZimbabweRésumé : A study was conducted in health institutions--urban as well as rural in the eight provinces of Zimbabwe to determine the attitudes of professional health workers (doctors, nurses, matrons, social workers and hospital administrators) to medically supervised abortion. The perception of the problem of abortion by health professionals, their knowledge of the present abortion law and desire for change were analysed. The majority of doctors were supportive of medically supervised abortion (61.2%) while the nurses were divided 43.2% for and 42.0% against but 14.8% were undecided. The administrators and social workers were supportive. Of the doctors 75% felt that the present abortion law was restrictive and 55.6% supported change. All health professionals agreed that the majority of women who present for abortion treatment are single. The surprising finding was that it is knowledge of the dire complications of unsafe abortion that determines one's attitude to abortion rather than religion. The present restrictive abortion laws which foster backstreet unsafe abortion need to be revised.
Source : source : Central African Journal of Medicine.Article de périodique
Mutungi A.K.; Wango E.O.; Rogo K.O.; Kimani V.N.; Karanja J.G.
Abortion: behaviour of adolescents in two districts in Kenya
1999 - East African Medical Journal, 76(10), p. 541-546.
Mots clés : méthodologie; enquête; adolescence; adolescent; grossesse adolescente; grossesse; avortement; comportement; connaissance, attitude; pratique; CAP; attitude; risque; étudiant; scolarisation; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : High rates of unwanted pregnancies among Kenyan adolescents resulted in many unsafe induced abortions, which are often associated with high morbidity and mortality. To evaluate the behavior of adolescents regarding induced abortion, a cross-sectional, prospective study was carried out in randomly selected schools and health facilities in two districts of Kenya between July 1995 and June 1996. Interviews were conducted among adolescents aged 10-19 years in schools (1048 girls and 580 boys), as well as adolescent girls who were in the immediate postabortion period (N = 192). Many adolescents were aware of the dangers of abortion. The awareness level of the risk associated with abortion was significantly lower among school boys (SBs) whose girlfriends (GFs) had aborted than among those whose GFs had not (p < 0.01). However, knowledge of the abortion risks had no influence on the choice of the abortionist. The practice of abortion was reported among 3.4% of schoolgirls (SGs), 9.3% of GFs of SBs, and among 100% of postabortion adolescents. Both the indirect and direct costs of abortion were heavy on the girls. From the findings, it is concluded that pregnant adolescents will still seek abortion services despite the knowledge of the risks involved.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150926.Article de périodique
Mutungi A.K.; Karanja J.G.; Kimani V.N.; Rogo K.O.; Wango E.O.
Abortion: knowledge and perceptions of adolescents in two districts in Kenya.
1999 - East African Medical Journal, 76(10), p. 556-561.
Mots clés : méthodologie; enquête; adolescence; adolescent; avortement; connaissance, attitude; pratique; CAP; perception; jeune; adolescent; âge; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A cross-sectional, descriptive study was carried out between July 1995 and June 1996 to determine Kenyan adolescents' perceptions of induced abortion (IA). Adolescents aged 10-19 years in schools of two districts (1048 girls; 580 boys) and a group of immediate postabortion adolescents (N = 192) in some health facilities in Nairobi constituted the study sample. A total of 1820 adolescents were subjected to a self-administered questionnaire, and focus group discussions were held with 12 groups of adolescents (N = 132) in schools. More than 90% of the participants were aware of IA. A positive correlation was observed between knowledge of IA and level of education (P < 0.01). Some 71% of the schoolgirls (SGs), 84% of the postabortion adolescents (PAs), and 40% of the schoolboys (SBs) were aware of abortion-related complications. The most common complications identified included infections, death, and infertility. 83% of PAs felt that complications were preventable by seeking care from a qualified doctor, compared to 25% each of the SBs and SGs. 56% of PAs, 69% of SBs, and 71% of SGs felt that abortions were preventable, while <40% proposed abstinence as a primary strategy. The most important sources of information on abortion were the media, friends, and teachers.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150929.Article de périodique
Andriamady R.C.L.; Rakotoarisoa; Ranjalahy R.J.; Fidison A.
Abortions at the Maternity Hospital of Befelatanana in 1997
1999 - Archives de l'Institut Pasteur de Madagascar, 65(1-2), p. 90-92Résumé : The purpose of this study is to assess the frequency of spontaneous and induced abortions at the Hospital Maternity of Befelatanana, in Antananarivo-City by 1997. The study was also carried out to identify causes and risk factors of abortions in order to draw up a control program. 958 abortion cases were counted. The patient average age was 28 old years. 289 cases (30.3%) of these abortions had complications. 1 out of 25 patients died. Some of causes of abortion have been specified: prior patient health, cultural, social and economic factors. Existence of abortions is a failure report of the Reproductive Health Program. Abortion control must be based on sanitary education in which family planning is very important, on correct management of abortion cases and their complications. But all that is not possible if there are not improvements of the standard of living.
Source : source : Archives de l'Institut Pasteur de Madagascar.Article de périodique
Berer M.
Access to reproductive health: A question of distributive justice
1999 - Reproductive Health Matters, 7, Issue 14, ,(14), p. 8-13
Mots clés : santé de la reproduction
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
The Alan Guttmacher Institute
An overview of clandestine abortion in Latin America
1999 - Issues in Brief, 6
Pays / Régions : Amérique Latine
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/ib12.html.Article de périodique
Okonofua F.E.; Odimegwu C.; Ajabor H.; Daru P.H.; Johnson A.
Assessing the prevalence and determinants of unwanted pregnancy and induced abortion in Nigeria
1999 - Studies in Family Planning, 30(1), p. 67-77
Mots clés : méthodologie; enquête; avortement; grossesse non prévue; grossesse non désirée; incidence; facteur socio-économique; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; mesure; facteur économique
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This study examined the prevalence and determinants of induced abortion in the Jos and Ife local government areas of Nigeria, a country that restricts abortion. Data were obtained from a survey conducted during 1995-96 among a systematic random sample of 1516 unmarried and married women 15-45 years old. Ife was largely Yoruba, while Jos was ethnically diverse. Over 25% in Ife were Muslims; over 50% in Jos were Christians. Ife respondents had greater knowledge of reproduction and family planning than those in Jos. More women had ever or currently used contraception in Ife. 20% of all women (19% in Ife and 21% in Jos) had an unwanted pregnancy (UP). Among women with UPs, 57.6% terminated it successfully. Around 30% took no action. 8.5% had unsuccessful terminations. About 19% of women with UPs became pregnant while using family planning. Well-educated women, women who were currently using a method, and women who correctly knew the most fertile period were each three times more likely to report a UP. Women who had knowledge of a modern method were twice as likely to report a UP. Women who had knowledge of family planning and women who were currently using a method were more likely to report an induced abortion. In Jos, women with a university education were more likely to report an induced abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 141311.Congrès
BM'Niya Bangamboulou D.
Avortement comme méthode de régulation des naissances : (Etude de cas au Gabon et en Centrafrique)
1999 - Séminaire International "Santé de la Reproduction en Afrique Pratique contraceptive et programmes de planification familiale, 9-12 novembre 1999, ENSEA, Abidjan, Côte d'Ivoire, p.
Mots clés : contraception; méthode contraceptive
Pays / Régions : Gabon
Source : source Ceped : http://ceped.cirad.fr.Congrès
Ouedraogo C.M.; Pictet G.
Avortement et pilule : mode de régulation de la fécondité
1999 - Séminaire International "Santé de la reproduction en Afrique" Pratique contraceptive et programmes de planification familiale, 9-12 novembre 1999, ENSEA Abidjan, 32p p.
Mots clés : contraception; méthode contraceptiveRésumé : Les femmes de Bazega, province rurale du Burkina Faso, préfèrent comme moyen de contrôle des naissances l'avortement à l'utilisation des méthodes contraceptives. En effet, de leur point de vue, il y a plus d'avantages à avorter qu'à recourir aux contraceptifs modernes. La pilule est même utilisée comme une méthode d'avortement. Les représentations relatives à la reproduction humaine ainsi que les perceptions des méthodes contraceptives modernes concourent à cette préférence. Néanmoins, des signes de changement sont perceptibles dans les comportements en matière de fécondité. Ces changements laissent présager une plus grande autonomie des couples et facilitent l'innovation dans le contrôle des naissances (Résumé d'auteur)
Source : source Ceped : http://ceped.cirad.fr.Chapitre d'ouvrage
Kouton E.F.; Pio A.B.; Fourn E.G.; Tossou J.Y.
Besoins en planification familiale et perspectives sur la fécondité au Bénin
1999 - Perspectives sur la planification familiale et la santé de la reproduction au Bénin : résultats d'analyses approfondies de la première enquête démographique et de santé au Bénin, p. p. 1-52. Calverton (US): Macro International Inc.
Pays / Régions : Bénin
Source : Source Ceped : http://ceped.cirad.fr.Chapitre d'ouvrage
Elu C.M.d.
Between political debate and women's suffering: Abortion in Mexico
1999 - In A.I. Mundigo et C. Indriso (Eds.), Abortion in the developing world, p. 245-258. New Delhi: WHORésumé : In Mexico, induced abortion is legal when there is: danger to the pregnant woman's life; the possibility of congenital defects; or pregnancy resulting from rape. Seven states allow abortion when pregnancy would jeopardize a woman's health, and one state allows abortion in cases of economic hardship. Despite the country's family planning policy, abortion rates are high and increasing. This study attempts to identify factors that contribute to the decision by women, particularly poor women, to undergo abortion under unsafe, dangerous conditions. The study also explores the perceptions, attitudes, and knowledge of health care providers, particularly hospital staff, of the motivations of abortion seekers. Structured interviews were carried out with 300 women admitted in the Hospital de la Mujer for abortion complications between August 15, 1990, and January 15, 1991, and with 142 hospital staff. For all the women interviewed, economic circumstances were a factor in the decision-making process. Male attitudes; unstable relationships; youthful age; and inaccessibility and unavailability of contraceptive methods all contributed to the decision to abort. Regarding the quality of health care for abortion complications, the women could have received better care if the health providers were more compassionate and well-trained and the facilities had appropriate equipment. Many of the hospital staff were fully aware of the need for safe abortion services, however, none of these providers agreed to perform an abortion. To prevent induced abortion and its consequences, it requires not only a modification of the many aspects of the maternal health care system but also an understanding of the complex cultural values that support its existence.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156349.Article de périodique
Mahler K.
Both unwanted pregnancies and abortions are common among women in Nigeria
1999 - International Family Planning Perspectives, 25(4), p. 207-208
Mots clés : méthodologie; enquête; femme; grossesse non prévue; grossesse non désirée; déterminant; prévalence; étudiant; scolarisation; santé de la reproduction; fécondité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; mesure
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This study assessed the prevalence and determinants of unwanted pregnancy and induced abortion in Nigeria. A total of 692 women in Ife and 824 women in Jos were interviewed to collect social and demographic data, information regarding women's reproductive history and knowledge, and contraceptive practices. A higher percentage of women in Jos had lesser education and were unemployed in comparison with Ife. Assessment findings revealed that 20% of women in each area reported having an unwanted pregnancy. Bad timing was the most common reason given by these women (48% in Jos and 31% in Ife), followed by a desire to stay in school (38% and 26%, respectively), and contraceptive failure (15% and 21%, respectively). About 58% of these women had an abortion, while 9% had an unsuccessful abortion. Overall, knowledge and current use of a contraceptive method was associated with increased odds of reporting a history of abortion. In conclusion, findings indicate that since Nigerian women often resort to abortion in the face of unwanted pregnancy, there is a need for contraceptive education and program initiatives focused on reducing the number of unwanted pregnancies and induced abortions.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2520799.html.Article de périodique
Bankole A.; Singh S.; Haas T.
Characteristics of Women who obtain induced Abortion: a worldwide review
1999 - International Family Planning Perspectives, 25(2), p. 68-77
Mots clés : méthodologie; avortement; demande; population; contraception d'urgence; contraception postcoitale; planning familial; facteur démographiqueRésumé : This study analyzed characteristics of women who obtained induced abortions. Data were obtained from national statistics, ad hoc surveys, and hospital reports. Statistical data were provided on the percentage distribution of abortions by age for the most recent year (1981-96) for 56 countries. Countries are grouped by level of reliability of data. Findings indicate that the highest number of abortions occurred among women 20-24 years old and 25-29 years old. The proportion of abortions among those under 20 years old was under 10% in 21 countries, 10-20% in 25 countries, and 20% or higher in 9 countries. Adolescents were a dominant user group in some countries, such as Nigeria, Cuba, Bulgaria, Estonia, Hungary, Romania, Russia, and the US. Adolescents may be a large proportion hospitalized for complications, such as in Lusaka, Zambia. Abortion ratios rose with age in most countries. Abortion ratios by age exhibited a U-shaped pattern. Compared to unmarried women, married women had a higher number of abortions in developed countries. 15 countries had higher unmarried abortion ratios than married ratios. Distribution by parity varied widely by country. More than 50% of abortions occurred among women with at least 1 child. Abortions varied by ethnicity in some countries. Abortions tended to be higher among educated women, but the education impact in some countries varied by age.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2506899.html.Article de périodique
Duncan G.
Collaborative research and development on mifepristone in China to reduce unwanted pregnancies and recourse to abortion.
1999 - Int J Gynaecol Obstet, 67 Suppl 2(dec 1999), p. S69-76
Mots clés : contraception d'urgence; contraception postcoitale; facteur économique; taux fécondité; fécondité; population; facteur démographique; contraception; méthode contraceptive; planning familial; programme
Pays / Régions : AsieRésumé : The proposed program of the Concept Foundation, which explores the introduction of mifepristone for postcoital, nonabortive contraceptive use in developing countries, is discussed. The program, entitled Collaborative Research and Development on Mifepristone to Reduce Unwanted Pregnancies and Recourse to Abortion , was proposed and funded for implementation in China. Recent clinical studies sponsored by the WHO Special Program of Research, Development and Research Training in Human Reproduction showed that a single 10 mg dose of mifepristone taken within 72 hours of unprotected sex is effective as emergency contraception (EC). Evidence also suggested that mifepristone, like the progestin only formulation, causes less nausea and vomiting than the Yuzpe EC regimen. The application of mifepristone to emergency, luteal phase, and menstrual induction contraception is being assessed in clinical research programs that are conducted in accordance with the international standards for good clinical research. The proposed project of the Concept Foundation in China includes six participating institutions. The structure of the program, its current status, impacts, and key requirements for success are discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147950.Article de périodique
Settergren S.
Community perspectives on unsafe abortion and postabortion care, Bulawayo and Hwange districts, Zimbabwe
1999 - 68-75
Mots clés : méthodologie; média; complication; soin post-abortum; service de santé; communication; contraception d'urgence; contraception postcoitale; planning familial; programme planning familial; soin; santé
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This paper presents the research findings of the first phase of a project, which focused on collecting information on community perspectives on unsafe abortion and postabortion care (PAC). The project utilized the methodology of social theater and aimed to promote community dialogue and actions. A series of performances of the drama "Don't--Ungaqali" was staged in Matebeleland North Province by the Amakhosi Theatre Group during November and December 1998. The play tells a story of a young girl who became pregnant, sought unsafe abortion, and suffered complications that left her with irrevocable damages. Post-performance discussions ranged in size from 18 to 100 participants and included members of specific stakeholder groups. Results indicate that community members view the issue of unsafe abortion from a broad perspective that includes family, community, and societal dimensions. This perspective focuses on the prevention of unwanted pregnancy and abortion. The obstacles identified in seeking PAC services are fears of legal prosecution and harsh treatment and exposure by nurses. Recommendations to increase the utilization of PAC services involve the identification of client and community needs. Client needs evolve around improving quality of services and offering confidentiality, support, and counseling. Community needs involve lifting legal restrictions on the provision of contraceptives to girls and the youth.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 146804.Congrès
Welffens Ekra C.; Yace Soumah F.; Goyaux N.
Complications des avortements provoqués au CHU de Yopougon (1993-1995)
1999 - Séminaire International "Santé de la reproduction en Afrique" Pratique contraceptive et programmes de planification familiale, Adidjan, ENSEA, IRD, Communication orale p.
Pays / Régions : Cote d'Ivoire
Source : source : ceped.Rapport
CERPOD
Conséquences sociales de l'avortement provoqué. Regards croisés sur une pratique persistante
1999 - CERPOD, Bamako, 24
Mots clés : législation; éducation
Pays / Régions : MaliRésumé : Faut-il risquer sa vie en optant pour l'avortement provoqué ou s'abstenir en s'exposant à la réprimande de la société ? Tel est le dilemme devant lequel nombre de femmes, en grossesse non désirée ou socialement non acceptée, ne résistent pas toujours en basculant dans la solution extrême. Se conformer aux normes sociales ou échapper aux sanctions sociales ? L'équation pousse encore des milliers de femmes, parfois avec l'accord tacite sinon l'encouragement de leur entourage à cet ultime recours qui s'appelle l'avortement provoqué. En effet, parmi les femmes qui avaient contracté une grossesse non désirée, plus de 7 sur 10 en consultation gynécologique et 4 sur 10 en consultation de planification familiale avaient finalement opté pour l'avortement provoqué comme solution à leur problème. Mais au-delà se cache un fait révélateur : le sentiment de "soulagement" et de "libération" reste partagé par 74% des femmes ayant connu au moins un avortement dans leur vie. Un nombre restreint d'entre elles, 30%, estiment que "l'avortement est une pratique à éviter". Et seulement 24,5%, éprouvent des remords voire des regrets après l'avoir tenté. Or les dégâts causés par la pratique de l'avortement provoqué sont inestimables à tout point de vue. A titre d'exemple une femme ayant connu l'avortement provoqué court quatre fois le risque de perdre son futur enfant que celle qui ne l'a pas pratiqué. Ce qui pose la réalité du problème de l'infécondité dont les femmes souffrent de plus en plus au Mali. S'y ajoute que la charge des complications consécutives à l'avortement (hémorragie, fièvre, troubles d'hypertension, perforations utérines, tétanos ...) repose entièrement sur les établissements hospitaliers, déjà débordés par une demande croissante. Le temps de rétablissement passé dans des hôpitaux, généralement dépourvus d'équipements adéquats, pose un autre problème de taille : celui du poids économique de l'avortement sur les patients eux-mêmes et sur les budgets dérisoires des hôpitaux de Bamako. Pendant ce temps, l'environnement légal et social n'offre pas une grande visibilité par rapport à la prise en charge de cette pratique. Les textes réglementaires demeurent encore inadaptés et restrictifs. Alors que les établissements hospitaliers publics et le personnel paramédical sont impliqués, d'une certaine manière, dans la prise en charge de l'avortement provoqué. Quant à la société, elle affiche une attitude mitigée, difficile à cerner. Toutes choses qui témoignent de la persistance de la pratique de l'avortement provoqué à Bamako (Résumé d'auteur)
Source : Source : Ceped.Article de périodique
Glover E.K.; Bannerman A.; Nerquaye Tetteh J.; Tweedie I.
Context and content of condom negotiation and sex refusal skills among youth in Ghana: key findings
1999
Mots clés : adolescence; adolescent; sexualité; santé de la reproduction; préservatif; contraception; avortement; jeune; adolescent; âge; population; facteur démographique; psychologie; facteur psychologique; comportement; fécondité; méthodes barrières; contraception; contraception; méthode contraceptive; planning familial; contraception d'urgence; contraception postcoitale
Pays / Régions : Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This paper presents the key findings of a study on the context and content of condom negotiation and sex refusal skills among youth in Ghana. A modified focus group technique using "storylines" to develop and narrate scenarios and interact among the youth between the ages of 15 and 22 was used. Overall, findings revealed that coercion and deceit were well-known and common elements of sexuality for the young people who participated in the study. The pressures to have sex were very strong. Friends, siblings, parents, teachers, prospective employees, doctors, clergy and others were cited by the participants as a party to these pressures. Moreover, some young women expressed the belief that sex is good for their health and condoms can be bad for their health. The issue of abortion was spontaneously discussed in many of the sessions. These discussions suggest that abortion may be a viable option of contraception for some young women. Implications for youth-centered reproductive health programs in Ghana are discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 154084.Congrès
Guillaume A.; Desgrées du Loû A.
Contraception et/ou avortement ? Une étude auprès de formations sanitaires d'Abidjan
1999 - Séminaire International "Santé de la Reproduction en Afrique", Abidjan, Côte d'Ivoire, 19p p.
Mots clés : contraception; méthode contraceptive
Pays / Régions : Cote d'Ivoire
Source : source : ceped : http://ceped.cirad.fr.Article de périodique
Ezechi O.C.; Fasubaa O.B.; Dare F.O.
Contraceptive promotion and utilization : solution to problem of illegally induced abortion in countries with restrictive abortion law
1999 - Nig. Qt. Hosp. Med., 9(2 april-june 1999), p. 167-168Résumé : This study examined the contraceptive utilisation among patients treated in a University Teaching Hospital for complications of illegal abortion aimed at utilizing such information to proffer solution to the problems of unwanted pregnancy and induced abortion. ln this study, 93.3% of patients had never used contraceptive and of this patients 31.1 % have had previous induced abortion. Also 94.7% of the patients who have had previous induced abortion had never used contraceptive. Contraceptive promotion and utilization were proffered as solution to the problem of unwanted pregnancy and induced abortion.
Source : source : Nig. Qt. Hosp. Med.Article de périodique
Nawar L.; Huntington D.; Abdel Fattah M.N.
Cost analysis of postabortion services in Egypt
1999 - 125-140
Mots clés : méthodologie; soin post-abortum; patient; aspiration; méthode; coût; santé de la reproduction; programme; programme planning familial; planning familial; avortement; contraception d'urgence; contraception postcoitale; soin; santé
Pays / Régions : Egypte; Afrique; Pays arabes; Pays MéditerranéensRésumé : This study presents the results from a cost analysis of postabortion services conducted as part of the 1996-97 expansion program of the medical procedures associated with adopting manual vacuum aspiration (MVA) within a package of improved quality of care. The study compared costs associated with treatment protocols of the two surgical methods, dilatation and curettage (DC) and MVA, used to treat postabortion patients through pre- and post-intervention surveys in two government hospitals in Egypt. Relying on direct observation of all elements contributing to treatment costs, and collecting hospital overhead costs, study findings indicate that the cost of materials and medicines is the major component of total per-patient cost. Such costs substantially increased with the adoption of MVA in the post-intervention. A major source of the increase was the cost of cannulas, which were not reused. This implies that in order to achieve the full benefit of MVA, its adoption should be accompanied by changes in hospital protocol that allow sterilization and reuse of cannulas. Another source of costs was the length of time patients stayed in the hospital during the post-intervention period. A decline in the post-intervention use of MVA allows patient to be discharged directly after treatment. In addition, use of MVA requires neither heavy sedation nor extended postoperative patient monitoring, unlike the method of DC. Several implications for the management of facilities, physicians and medical staff are cited in this article.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147373.Article de périodique
Solo J.; Billings D.L.; Aloo Obunga C.; Ominde A.; Makumi M.
Creating linkages between incomplete abortion treatment and family planning services in Kenya
1999 - 38-60
Mots clés : méthodologie; soin post-abortum; programme planning familial; traitement; soin; hôpital; hospitalisation; service de santé; complication; mesure; planning familial; santé de la reproduction; soin; santé; avortement; contraception d'urgence; contraception postcoitale
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This study determines the most effective, feasible, and acceptable ways to deliver postabortion family planning counseling and methods in a hospital setting. Three different models of providing postabortion family planning were tested. These models varied in instances of where services were offered and who provided the services. Based primarily on a caseload of women presented with incomplete abortion, six public hospitals in Kenya were chosen as study sites. Training in both manual vacuum aspiration and postabortion family planning of gynecological ward staff were held, and structured interviews were conducted with patients, staff, and patients' partners during pre-intervention and post-intervention phases. Overall findings of the study show that the provision of postabortion family planning services on the gynecological ward by ward staff was the preferred model (Model 1). This model will be promoted for providing postabortion family planning services. However, ministry planners recognize that this model might not be feasible for all sites. Several recommendations for the implementation of this model are specified.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147369.Chapitre d'ouvrage
Akin A.
Cultural and psychosocial factors affecting contraceptive use and abortion in two provinces of Turkey
1999 - In A.I. Mundigo et C. Indriso (Eds.), Abortion in the developing world, p. 191-211. New Delhi: WHO
Mots clés : méthodologie; homme; décision; planning familial; genre; comportement
Pays / Régions : Turquie; Moyen Orient; Asie; Pays MéditerranéensRésumé : In Turkey, withdrawal is the most commonly used family planning method among currently married women, and it represents 41% of total contraceptive prevalence. The ineffectiveness of this method may contribute to the increasing rate of induced abortion, which was legalized in Turkey in 1983. This study aims to understand the cultural determinants of abortion and the relationship of abortion to the other methods of fertility regulation in two provinces, Ankara and Van. The study was conducted in three phases: 1) 25 focus group discussions among married women; 2) interviews with 1085 samples (both men and women); and 3) in-depth interviews among 35 pregnant women. The primary determinant of abortion practice is the high reliance on withdrawal, the continued popularity of which method relates to the active role of men in reproductive decision making, irrespective of urban/rural variations. The use of effective contraceptive methods was higher when the educational level of the man was higher, in both provinces. Other socioeconomic factors that possibly have a degree of influence on couple's choice of withdrawal were related to service delivery. Socioeconomic views on induced abortion were related to the character of gender relations among couples. Recommendations and policy impact are discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156346.Article de périodique
Rogo K.O.; Bohmer L.; Ombaka C.
Developing community-based strategies to decrease maternal morbidity and mortality due to unsafe abortion: pre-intervention research report
1999 - East African Medical Journal, 76(11 Suppl), p. S1-71
Mots clés : méthodologie; complication; mortalité maternelle; morbidité; service de santé; service de santé communautaire; offre; service de santé; complication grossesse; maladie; complication; mortalité; population; facteur démographique; soin de santé primaire; soin; santé
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Africa, unsafe abortion is a public health problem of enormous consequence accounting for 20-50% of all pregnancy-related mortality. In view of this, the Pacific Institute for Women's Health, in collaboration with the Nairobi-based center for the Study of Adolescence, conducted a preintervention exploratory research to better understand unsafe abortion within several communities in Nyanza Province, western Kenya. Using qualitative methods, the study was carried out in two phases: an initial phase of 32 focus groups and a subsequent phase of 74 in-depth semistructured interviews. Results are summarized under the following headings: sociocultural context of unwanted pregnancy and abortion; providers and methods of abortion; community perceptions of provider safety; consequences of abortion; postabortion care; male involvement in abortion decision-making and care; involvement of family and friends; legal attitudes towards abortion; contraceptives--attitudes and access; and community perspectives on interventions. Recommended areas of intervention include prevention of unwanted pregnancies and unsafe abortions, increasing access to safe affordable abortion services and postabortion care, and addressing the legal and policy issues related to sexuality, contraception, and abortion. The future direction of the project is also discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 151395.Article de périodique
Okanlomo K.A.; Ngotho D.; Moodley J.
Effect of misoprostol for cervical ripening prior to pregnancy interruption before twelve weeks of gestation
1999 - East African Medical Journal, 76(10), p. 552-555
Mots clés : méthodologie; Misoprostol; méthode; aspiration; méthode; dilatation curetage; méthode; avortement; contraception d'urgence; contraception postcoitale; planning familial; traitement; soin
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This randomized control study evaluated the effectiveness of performing manual vacuum aspiration (MVA) with and without the use of misoprostol in South Africa. The study sample comprised 136 women at 6-12 weeks of gestation; 70 were assigned to the misoprostol group. Of these, 11 (15%) did not show any change in cervical score. Their mean cervical dilatation was similar to the control group (3.3 vs. 31; p > 0.06). In the group whose gestational age was <8 weeks, the time taken to complete the procedure, the quantity of products of conception, and cervical dilatation were statistically significant except in the primigravidas. On the other hand, in pregnancies >8 weeks of gestation, all parameters assessed, such as cervical dilatation and quantity of products of conception, were significantly different from the control group, in both multigravidas and primigravidas. Pain score was similar for all gestations. From the findings, it was concluded that misoprostol is of specific value during MVA for voluntary interruption of pregnancy.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150928.Article de périodique
Dickson Tetteh K.; Rees H.
Efforts to reduce abortion-related mortality in South Africa
1999 - 190-195
Mots clés : loi; mortalité maternelle; politique; législation; avortement; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Safe and legal abortion was never accessible to many women in South Africa. The service was limited to a few wealthy women who could afford to pay a willing gynecologist to guide them through the bureaucratic process required by the state before a pregnancy could be terminated. National data recorded that some 425 women died in hospitals each year from complications of unsafe, clandestine abortions, and some 14,000 or more per year attended hospitals for treatment of complications. However, after South Africa's first democratic elections in 1994, a constitution, which recognizes gender and reproductive rights, prevailed, making it possible for abortion law to be implemented. The Choice on Termination of Pregnancy Act came into force in February 1997. This Act permits the termination of pregnancy upon request of the woman up to 12 weeks of pregnancy, and on certain defined grounds after 13 weeks of pregnancy. Descriptions of the requirements of the Act, its implementation through a National Abortion Care Programme, and the details of a national curriculum and training program for physicians and midwives who are gradually setting up services are presented in this article.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147676.Ouvrage
Zanou B.; Desgrées du Loû A.; Guillaume A.; Koffi N.G.; Maniraguha P.; Ramde F.B.; Razamparany M.; Rakotoarisoa A.H.; Dopamas M.
Etude démographique et de santé maternelle dans la sous-préfecture de Niakaramandougou (Centre-Nord)
1999 - Abidjan (CI): ENSEA, 123 p. p.
Pays / Régions : Cote d'IvoireRésumé : La présente étude est l'analyse des données de l'enquête démographique et de santé maternelle à Niakaramandougou" effectuée du 1 er au 18 Avril 1998. L'enquête s'est déroulée dans l'observatoire de population mis en place par l'ENSEA en 1997. C'est une région de Savane située au Centre- Nord de la Côte-d'Ivoire, peuplée de Tagbana, un sous-groupe des Sénoufo. Les habitants de l'observatoire sont en majorité catholiques, agriculteurs et analphabètes. Plus de 46 % de la population ont moins de 15 ans. Le taux de scolarisation reste faible, la situation étant plus alarmante chez les filles (49 %) que chez les garçons (62%). Le taux d'accroissement moyen de la population sur les 10 dernières années est de 2,5 % par an. Malgré une amorce de baisse, la fécondité reste le facteur le plus impliqué dans la croissance de la population: 6,1 enfants par femme est la situation du moment. La baisse de la fécondité surtout chez les jeunes femmes (15-19 ans), résulte à la fois de l'augmentation de l'âge d'entrée dans la vie procréative et de l'utilisation des mécanismes traditionnels et modernes de régulation des naissances. Mais, si le niveau de la fécondité reste élevé, c'est que les mécanismes traditionnels sont en régression et que la pratique contraceptive moderne met du temps à pénétrer le milieu : 10 % seulement des femmes interrogées ont utilisé une méthode moderne et 14 % une méthode traditionnelle. Le manque de structure pouvant donner des conseils dans le domaine de la planification familiale amène certaines femmes à recourir à J'avortement comme moyen de régulation des naissances. Bien qu'en proportion faible pour le moment (7,8 % des femmes de 15 à 49 ans) ce phénomène mérite d'être pris en compte dans l'élaboration des programmes de santé publique. Le principe de surveillance de la grossesse semble acquis dans cette population, puisque 96 % des femmes ayant eu une grossesse ont été au moins une fois en consultation prénatale. Cependant, seules 45 % de ces femmes ont effectué les 4 consultations recommandées pour un bon suivi de la grossesse. Par ailleurs, 20 % des femmes continuent d'accoucher à domicile sans assistance médicale. Ces comportements ont des impacts certains sur les fausses couches et les mort-nés.
Source : Source Ceped : http://ceped.cirad.fr.Congrès
Pagezy H.
Fécondité et comportement féconds dans la boucle du Ntem (Camerou) : analyse diachronique
1999 - Séminaire International "Santé de la Reproduction en Afrique Pratique contraceptive et programmes de planification familiale, 9-12 novembre 1999, ENSEA, Abidjan, Côte d'Ivoire, 16p p.
Source : source : ceped.Chapitre d'ouvrage
Ehrenfeld N.
Female adolescents at the crossroads: Sexuality, contraception and abortion in Mexico
1999 - In A.I. Mundigo et C. Indriso (Eds.), Abortion in the developing world, p. 368-386. New Delhi: World Health OrganizationRésumé : Abstract: This study sought to identify the determinants of the decision to continue or interrupt an unplanned pregnancy among adolescents 12-19 years old, by examining the circumstances and sociocultural conditions underlying such a decision. The study sample, gathered using the quota system, included 72 adolescent girls who requested services related to their pregnancies at the Obstetrics and Gynecology Clinic of the Hospital General Dr. Manual Gea Gonzales, Mexico City. Generally, mothers and boyfriends were the two most influential figures when a girl was faced with deciding whether to continue with the pregnancy or to have an abortion. A very significant factor in the decision-making process for low-income girls was her economic situation. Economic constraints lead girls to make several unsuccessful self-induced attempts at abortion, which include strong injections; injections of Metrigen; tea infusions of spices such as oregano and cinnamon; and infusions of xoapactle. From the findings, provision of sexual and reproductive health education, family planning programs, and medical training and hospital services are essential in reducing unwanted pregnancies and abortions.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156356.Congrès
Mturi A.J.; Hlabana T.
Fertility in Lesotho recent trends and proximate determinants
1999 - Third African population conference, " the African Population in the 21st century", 6-10 December 1999, Durban, South Africa, UAPS/UEPA/NPU, 145-162 p.
Mots clés : revue littérature; enquête; fécondité; déterminant fécondité; transition fécondité; étudiant; scolarisation; méthodologie; population; facteur démographique; taux fécondité; taux natalité
Pays / Régions : Lesotho; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : It has been documented that the fertility transition is clearly underway in South Africa, particularly in Zimbabwe, Botswana, and the Republic of South Africa. However, very little has been written about fertility in Lesotho. This paper is an attempt to fill this gap. The 1986 Lesotho population census suggests that total fertility rate (TFR) was >5 births per woman. However, the census estimated a TFR of 4.1. This shows that fertility is declining in this country, and that Basotho women have the lowest fertility level in sub-Saharan Africa. The proximity determinants of fertility in Lesotho are categorized into three. The first category comprises those determinants, which have small effect on fertility, which includes induced abortion and sterility. Category two includes those determinants which have a substantial effect on reducing fertility below its natural maximum but they have not changed much over time in Lesotho. These are breast-feeding and marriage. The third category includes those determinants, which change over time and contribute substantially in the recent declining trend in observed fertility. Use of contraception and spouse separation form the third category. The paper argues that further fertility decline in Lesotho will depend on the expansion of the intake of family planning supplies. This will necessitate a strong government commitment to the family planning program in order to realize the government's target of reducing TFR of Basotho women to 2.1 by the year 2011.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 152693.Article de périodique
Hord C.E.
ICPD Paragraph 8.25: a global review of progress
1999
Mots clés : adolescence; adolescent; loi; santé publique; programme de santé; demande; programme; jeune; adolescent; âge; population; facteur démographique; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé; politique; programme; facteur économique
Pays / Régions : AfriqueRésumé : The Paragraph 8.25 of the International Conference on Population Development calls for safe abortion, where it is legal, clearly identifies unsafe abortion as a public health problem, and outlines a number of approaches that governments, intergovernmental agencies, and nongovernmental organizations can take to improve the situation. This document offers a preliminary and non- exhaustive review of progress achieved, obstacles encountered, and key areas for attention in the future for those working on the issues addressed in Paragraph 8.25.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 169972.Article de périodique
El Shafei M.; Hassan E.O.; Mashalli A.E.; Shalan H.; El Lakkany N.
Improving reproductive health service by using manual vacuum aspiration in the management of incomplete abortion
1999 - Egyptian Society of Obstetrics and Gynecology, 25(10-12), p. 711-722
Mots clés : méthodologie; enquête; aspiration; méthode; curetage; méthode; complication; étudiant; scolarisation; avortement; contraception d'urgence; contraception postcoitale; planning familial; intervention chirurgicale; méthode; intervention chirurgicale; traitement; soin
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : This prospective study recruited 400 cases of incomplete abortion in the first trimester of pregnancy, and uterine evacuation was performed in 300 cases using manual vacuum aspiration (MVA) (group I), while in 100 cases sharp curettage was used to evacuate the uterus (group II). The aim of the study was to compare MVA and sharp curettage in the management of incomplete abortion as a way to improve the health care for abortion cases and to reduce abortion-related maternal morbidity and mortality. MVA has proved to be an effective method for the treatment of incomplete abortion, with the following advantages over the traditional method of sharp curettage: no need for general anesthesia in most cases; shorter operating time (11 vs. 18.3 minutes); shorter hospital stay (2.4 vs. 9.2 hours); less blood loss (3% vs. 14%, P < 0.001); less postoperative severe lower abdominal pain and infection; and lower incidence of postoperative bleeding. Therefore, MVA seems to be a simple, safe, and effective method for the management of incomplete abortion, with less complications compared to sharp curettage, and could replace the traditional method to improve reproductive health care and reduce maternal morbidity and mortality. (author's, modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 162287.Article de périodique
Meskel Y.W.; Chekol A.
Induced abortion and prevalence of sexually transmitted diseases and contraceptive behavior in abortion cases, Gambella Hospital, south west
1999 - Ethiopian Journal of Health Sciences, 9(2), p. 77-83
Mots clés : méthodologie; enquête; taux; avortement; avortement spontané; fausse couche; maladie sexuellement transmissible; MST; IST; contraception; méthode contraceptive; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; IST; MST; infection; complication
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : A descriptive prospective study to know the prevalence of induced abortion and sexually transmitted diseases (STDs) and contraceptive behavior, was conducted on patients admitted to the gynecology ward at Gambella Hospital, southwest Ethiopia, from June 1997 through May 1998. 70% (N = 167) of the patients were cases of abortion, of which 35.7% and 64.3% were cases of induced and spontaneous abortion, respectively. Patients with induced abortion were younger (P-value < 0.05) and were more likely to be single as compared to patients with spontaneous abortion. Most of the patients with induced abortion had a secondary education (46%), while most with spontaneous abortion were illiterate (84.2%) and housewives (64.8%). More complications were observed in induced abortion patients, and pelvic infection was the most frequent one (41.6%). Metallic materials were common instruments employed (44.8%). 14 (12.2%) of the abortion patients had a history of STDs, with no statistically significant difference between induced and spontaneous abortion cases. 69% of abortion patients had knowledge about at least one method of modern contraceptives, of whom induced abortion cases had significantly more knowledge than spontaneous abortion cases (P-value < 0.05), and the pill was most commonly known. More than half (51%) of the patients who had contraceptive knowledge had never used any contraceptive method. Sex education, cultural modification, and accessing and improving health facilities are recommended. (author's, modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 152364.Chapitre d'ouvrage
Mpangile G.S.; Leshabari M.T.; Kihwele D.J.
Induced abortion in Dar es Salaam, Tanzania: the plight of adolescents
1999 - In Axel I Mundigo et C. Indriso (Eds.), Abortion in the developing world, p. 387-403. New Delhi: World Health Organization
Mots clés : méthodologie; enquête; adolescence; adolescent; pauvreté; femme; complication; coût; facteur socio-économique; contraception d'urgence; contraception postcoitale; planning familial; jeune; adolescent; âge; population; facteur démographique; facteur économique
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This study was undertaken in four public hospitals in Dar es Salaam, Tanzania, to describe the socioeconomic and demographic profile of low-income women as well as their fertility regulation behavior. It also explored the circumstances surrounding the abortion experience with regards to health complications and costs. A total of 455 women who had had an induced abortion comprised the study population. The study results indicate that there is a public health problem in Tanzanian society associated with unsafe abortion practices. One-third of the victims of unsafe abortion were teenagers, of whom half were 17 years of age or younger. About 1 in every 4 were students in primary or secondary school. The study exposed the lack of knowledge about contraceptives among the young women. 59% of the respondents, most of whom were teenagers and students, who first confided in a close female relative were advised to terminate the pregnancies. The financial implications for the individual woman undergoing induced abortion are immense, and especially when she is poor, a teenager, single, a student, or abandoned by the male partner. The study found potentially serious complications among the majority of patients from incomplete abortion. The longer-term complications of unsafe abortion practices include gynecological disorders, sterility, spontaneous abortions, cervical incompetence, and premature births. Recommendations for curbing unwanted pregnancy and unsafe abortion are discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156357.Article de périodique
Koster Oyekan W.
Infertility among Yoruba women : perceptions on causes, treatments and consequences
1999 - African Journal of Reproductive Health (NG), 3(1), p. p. 13-26
Mots clés : méthodologie; femme; stérilité; traitement; soin; médecine traditionnelle; méthode; déterminant culturel; population; facteur démographique; santé de la reproduction; médecine; service de santé; soin; santé
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This article presents preliminary findings from applied anthropological research on fertility regulation among the Yoruba of Nigeria and explains how Yoruba women and local providers of fertility regulation services perceive the causes, treatments and consequences of infertility. The fieldwork took place in the heart of Lagos, where most of the residents were Yoruba. Data on the issue of fertility regulation were collected through interviews with various traditional healers and their clients and with staff from the maternity hospital. Fertility and infertility were found to be the central issue in Yoruba life, as it determined the social position, sense of fulfillment, and personal happiness among women. The Yoruba regarded infertility as a non-natural state of affairs. A majority of the respondents alluded to several cause of infertility; most of them were considered spiritual. Infertility, it was felt, made a woman's life useless; therefore, the threat of infertility loomed over her happiness not only because it threatened her sense of personal fulfillment but also because it prevented her from feeling that she was a full and respected member of society. The threat of infertility caused women to make decisions that were actually out of harmony with their traditions. Since the Yoruba regard infertility as a serious health and social problem, infertility should be addressed as a public health problem. Orthodox medicine and traditional healers should work together in the effort to integrate treatment of infertility into regular public/reproductive health services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 143598.Chapitre d'ouvrage
Indriso C.; Mundigo A.I.
Introduction
1999 - In A.I. Mundigo et C. Indriso (Eds.), Abortion in the developing world, p. 23-53. India/New Delhi: WHORésumé : Induced abortion continues to result in the needless deaths and serious illnesses of the poorer women in the developing world. The Task Force for Social Science Research on Reproductive Health of the Special Programme of Research, Development and Research Training in Human Reproduction launched a major research initiative in 1989 on the determinants and consequences of induced abortion, with a focus on developing countries. Emphasis was given to projects from countries where abortion laws were restrictive, although some studies were supported in countries where abortion was legal, but services were not always accessible nor of good quality. The primary goal of the project was to increase knowledge of why women seek abortion, even in contexts where family planning services are widely available and where abortion is punishable by law. This paper provides a brief overview of the research studies conducted in developing countries worldwide.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156338.Congrès
Makdessi Y.; Tamouza S.
L'état de santé des mères en Algérie et au Liban
1999 - Arab Conference on Maternal and Child Health, Le Caire (EG) 1999/06/7-10, 24 p. p.
Source : Source Ceped : http://ceped.cirad.fr.Ouvrage
Pictet G.; Guiella G.; Ouedraogo C.M.; Baya B.
La planification familiale a-t-elle un sens en Afrique rurale? L'exemple du laboratoire de santé communautaire de Bazéga (Burkina Faso)
1999 - Ouagadougou (BF): UERD, 56 p. p.
Mots clés : religion
Pays / Régions : Burkina FasoRésumé : Les programmes de planification familliale (PF) en Afrique rurale connaissent des succès au mieux mitigés. Dans ce document, les auteurs passent en revue les hypothèses explicites et implicites des programmes de PF et discutent de leur validité à la lumière des résultats des enquêtes quantitatives et qualitatives qu'ils ont menées au Bazèga dans le cadre du Laboratoire de Santé Communautaire (LSC). Ils analysent, sur la base d'entretiens de groupe et d'une enquête auprès de 2804 femmes de 15 à 49 ans les changements dans les pratiques de régulation de la fécondité; les besoins et la demande en méthodes contraceptives; les effets des connaissances, attitudes et pratiques en matière de planification familiale sur la demande en méthodes de contraception moderne et les relations entre l'utilisation de contraception et l'offre de PF (Résumé d'auteur)
Source : Source Ceped : http://ceped.cirad.fr.Rapport
Bonnet D.; Guillaume A.
La Santé de la reproduction : concept et acteurs
1999 - Equipe de recherche Transition de la Fécondité et Santé de la reproduction (IRD), Paris, 20Résumé : L'article analyse le concept de "santé de la reproduction" dans une perspective historique à partir des déclarations et des actions des organismes internationaux d'où il a émergé sous l'influence des organisations non gouvernementales et des mouvements féministes. Se substituant à la notion de "santé maternelle et infantile", il inclut aujourd'hui la santé sexuelle et la régulation de la fécondité. La santé de la reproduction ne concerne donc plus uniquement la santé de la mère et de l'enfant mais aussi celle des adolescents, des femmes ménoposées et des hommes. Elle dépasse le strict cadre médical pour poser la question de la responsabilité individuelle et collective dans les comportements sexuels et reproductifs. De cette évolution conceptuelle découle la notion de "droit reproductif" qui implique une liberté de choix en matière de sexualité et de fécondité. Ces déclarations et revendications restent néanmoins en grand décalage avec l'organisation sociale et politique des pays concernés. Même si les états qui ont participé à la Conférence du Caire sur la population en 1994 ont manifesté un certain consensus sur les orientations générales en matière de santé de la reproduction, ils ont laissé, malgré tout, transparaitre des divergences sur des questions religieuses et politiques. Le cas de l'avortement, décrit ici, en est une bonne illustration (Résumé d'auteur)
Source : Source Ceped : http://ceped.cirad.fr.Rapport
Guillaume A.; Desgrées du Loû A.; Koffi N.G.; Zanou B.
Le recours à l'avortement : la situation en Côte d'Ivoire.
1999 - ENSEA, IRD, Abidjan, 50 p.
Mots clés : contraception; méthode contraceptiveRésumé : A partir d'enquêtes menées en Côte d'Ivoire dans différentes régions, cette étude présente la situation du recours à l'avortement ainsi que les pratiques en matière de planification familiale. Ce recours à l'avortement est fréquent puisque selon les régions considérées entre 7 % et 33 % des femmes déclarent avoir fait au cours de leur vie au moins un avortement. Ce phénomène se généralise dans certains groupes de population et en particulier dans les villes. Il touche plus particulièrement les femmes instruites et les femmes non en union pour lesquelles une grossesse peut constituer des problèmes tant sociaux qu'économiques. Mais cette pratique de l'avortement est également développée (dans une moindre mesure) chez les femmes en union stable, intervenant comme mode de régulation de la fécondité, ainsi que chez les jeunes femmes dès leur première grossesse pour éviter une grossesse non désirée. Plus de la moitié de ces avortements déclarés sont faits dans des structures médicales sans que l'on connaissance réellement les conditions sanitaires de cet acte, mais une part importante des femmes l'ont fait soit à domicile soit chez un thérapeute traditionnel : autant de pratiques lourdes de conséquences pour la santé des femmes. Cette pratique de l'avortement révèle un besoin non satisfait de planification familiale: le niveau de connaissance et d'utilisation des méthodes contraceptives est d'ailleurs très variable selon les régions et dépendant de l'accessibilité à de tels programmes.
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Desgrées du Loû A.; Msellati P.; Viho I.; Welffens Ekra C.
Le recours à l'avortement provoqué à Abidjan. Une cause de la baisse de la fécondité?
1999 - Population, 54(3), p. 427-446
Mots clés : méthodologie; ville; résidence; déterminant fécondité; avortement; incidence; population; facteur démographique; fécondité; contraception d'urgence; contraception postcoitale; planning familial; mesure
Pays / Régions : Cote d'Ivoire; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : En Côte d'Ivoire, la fécondité a baissé rapidement au cours des quinze dernières années : le nombre moyen d'enfants par femme est passé de 7,2 en 1980 à 5,7 en 1994, et ce malgré une prévalence contraceptive encore très faible. Parmi les différents moyens d'espacement des naissances possibles, il en est un qui reste très mal connu dans ce pays, car illégal et souvent clandestin : le recours à l'avortement provoqué. Cette étude présente les niveaux de recours à l'avortement et leur évolution, à partir des vies génésiques de 1201 femmes enceintes dans la ville d'Abidjan. Il semble qu'il y ait actuellement en Côte d'Ivoire un recours à l'avortement provoqué fréquent (un tiers des femmes ont avorté au moins une fois), et que ce phénomène se soit récemment amplifié. La généralisation du recours à l'avortement se serait faite au cours des dix dernières années ; elle a touché toutes les classes d'âge, mais plus particulièrement les plus jeunes qui commencent à utiliser l'avortement dès le début de leur vie féconde, au contraire de leurs aînées qui l'utilisaient plutôt comme un moyen d'espacement et de limitation des naissances après les premières grossesses. Cette augmentation rapide du recours à l'avortement explique en partie la baisse de fécondité de la Côte d'Ivoire.
Source : source Population : http://www.ined.fr/publications/population/index.html.Congrès
Goyaux N.; Thonneau P.
Les complications obstétricales du 1er trimestre de la grossesse (avortement provoqué, fausse couche, grossesse extra-utérine): résultats préliminaires de la recherche multicentrique (CEE/INSERM)
1999 - Santé de la reproduction en Afrique, Abidjan, Côte d'Ivoire, communication orale p.
Mots clés : complication
Pays / Régions : Cote d'Ivoire
Source : source : Ceped.Rapport
Konate M.K.; Sissoko F.; Guèye M.; Traore B.; Diabaté D.F.S.
Les conséquences sociales de l'avortement provoqué à Bamako
1999 - CILSS, INSAH, CERPOD, Bamako, 91Résumé : Although induced abortion is officially illegal in Mali except to save the life of the mother, abortion practitioners and patients are rarely prosecuted. Preliminary quantitative findings are presented of a Center for applied Research on Population and Development (CERPOD) study conducted in Bamako during 1995-96 on the social consequences of induced abortion. The quantitative component of the study explored the sociodemographic characteristics and the contraceptive and abortion histories of a random sample of reproductive health clinic clients in the nation's capital. First, a pre-test was conducted involving 999 randomly selected female patients from four family planning and prenatal clinics and one hospital-based gynecological care unit in the city. That pre-test was then followed by a full-scale survey of more than 3000 randomly-selected, ever-sexually-active female patients of three of the four clinics and the hospital unit upon their exit from a medical consultation. One in seven women in the study population had attempted an abortion and 14% were suffering from abortion-related complications at the time of the interview. Induced abortion was most frequently reported by women attending gynecological care consultations. Comprehensive findings are presented.
Source : source : Ceped.Congrès
Yace Soumah F.; Welffens Ekra C.; Goyaux N.
Les méthodes d'avortement provoqué à Abidjan(département de gynécologie et d'obstétrique du CHU de Yopougon)
1999 - Séminaire International "Santé de la reproduction en Afrique" Pratique contraceptive et programmes de planification familiale, 9-12 novembre 1999, ENSEA, Abidjan Côte d'Ivoire, p.
Pays / Régions : Cote d'Ivoire
Source : source :ceped.Article de périodique
Jeppsson A.; Tesfu M.; Bohmer L.
Magnitude of abortion-related complications in Ethiopian health facilities: a national assessment
1999 - East African Medical Journal, 76(10), p. 547-551
Mots clés : méthodologie; enquête; complication; service de santé; traitement; soin; contraception d'urgence; contraception postcoitale; planning familial; soin; santé; programme
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : This cross-sectional, descriptive study determined the magnitude of abortion-related complications, available treatment, and referral arrangements at various levels of the Ethiopian health system. A total of 20 hospitals and 12 health centers were visited and a physician working in each facility was interviewed. In hospitals, the interviewees estimated that an average of 17 patients with postabortion complications were seen per month. In lower-level health facilities providing postabortion care, the estimate was 1 patient per month. In lower-level units not providing postabortion services, 84% of the interviewees responded that they saw patients with complications due to abortion. Moreover, findings indicate that abortion complications occur in both urban and rural areas and were seen not only in hospitals but also in health centers and health stations, of which many were ill equipped to handle the patients. These results suggest the need to address services to improve treatment of abortion complications and other reproductive health services, as well as the provision of education to prevent unsafe abortion with both communities and lower-level health facilities that serve them.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150927.Article de périodique
Anonymous
Mali adolescents: early parenthood does not equal more choice
1999 - Reproductive Freedom News, 8(10), p. 2
Mots clés : adolescence; adolescent; santé de la reproduction; femme; droit; excision; issue grossesse; grossesse; complication grossesse; loi; jeune; adolescent; âge; population; facteur démographique; santé; maladie; complication; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Mali; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : This paper highlights the impact of laws and policies on reproductive rights in adolescents and young girls in Mali. The Center for Reproductive Law and the Association of Women Lawyers in the country uncovered several areas of concern on the adolescents in Mali. It was noted that 94% of the women in reproductive age have undergone female genital mutilation, also known as female circumcision. According to the report, 34% of the female adolescents have experienced pregnancy despite their knowledge that early pregnancies are critical risk factors in maternal and infant mortality. The adolescent pregnancy is attributed to their law, which permits girls to marry at an early age. Moreover, the low level of knowledge on contraceptives contributed to the increasing incidence of HIV/AIDS infection in the country. Also documented was the outlawing of abortion in Mali and is permitted only when the life of the woman is at risk. Because of this, adolescents flood to illegal abortions, putting themselves at risk of infection and complications. In response to this report, the UN recommended that Mali government should establish strategies against maternal mortality.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 145811.Article de périodique
Lankoande J.; Ouedraogo C.M.; Ouedraogo A.; Tieba B.; Akotionga M.; Sanou J.; Kone B.
Maternal mortality in adolescents at the University Hospital of OuagadougouLa mortalite maternelle chez les adolescentes au C.H.U. de Ouagadougou
1999 - Revue Medicale de Bruxelles, 20(2), p. 87-89
Mots clés : méthodologie; mortalité maternelle; adolescence; adolescent; grossesse adolescente; grossesse; incidence; complication; anémie; complication; décès; mortalité; population; facteur démographique; jeune; adolescent; âge; santé de la reproduction; fécondité; mesure; avortement; contraception d'urgence; contraception postcoitale; planning familial; maladie; complication
Pays / Régions : Burkina Faso; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Results are presented from a study conducted to assess the vulnerability of female adolescents facing pregnancy and delivery in order to more effectively advocate for the strengthening of adolescent health and education programs in Burkina Faso. The authors report results from a retrospective study upon maternal mortality among adolescents in the maternity ward of Ouagadougou's University Hospital in 1995. Included in the study are adolescents having delivered in hospital and those perishing during pregnancy, labor, delivery, or within 42 hours of giving birth. There were 20 maternal deaths among the 646 adolescent deliveries yielding 490 live births. In-hospital maternal mortality among adolescents was 4081 deaths per 100,000 live births, compared to the national maternal mortality rate of 556/100,000. The maternal mortality rate observed in this study is higher than results obtained from some other comparable studies. This mortality represents 16.3% of all maternal deaths recorded during the study period. Study subjects were 13-19 years old. Main causes of death were illegal induced abortion in 30% of cases and chronic anemia in 30% of cases associated with malnutrition. Factors contributing to the toll of maternal mortality are the lack of surgical equipment in one case and the unavailability of blood transfusion in 6 cases of death due to chronic anemia. Adolescent pregnancy deserves particular attention.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156842.Article de périodique
Hoj L.; Stensballe J.; Aaby P.
Maternal mortality in Guinea-Bissau: the use of verbal autopsy in a multi-ethnic population
1999 - Int J Epidemiol, 28(1), p. 70-76.
Mots clés : méthodologie; enquête; mortalité maternelle; décès; sexualité; étudiant; scolarisation; mortalité; population; facteur démographique; mesure
Pays / Régions : Guinée Bissau; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : The use of verbal autopsy to ascertain the cause of maternal deaths was assessed in a cohort of 15,832 women of reproductive age from 100 clusters in Guinea-Bissau. There were 350 deaths in this cohort during the 6-year study period. Diagnostic algorithms for the most common causes of maternal mortality were employed in interviews with close relatives and birth attendants. 111 (32%) of the deaths occurred during pregnancy or within 42 days after delivery. 78 (70%) of these deaths could be further categorized as direct obstetric, indirect obstetric, or coincidental mortality and, in 69 cases, a possible or probable gynecologic-obstetric diagnosis could be made. The most frequent diagnoses were postpartum hemorrhage (42%), obstructed labor (19%), and puerperal infection (16%). The recall period averaged 2.4 years (range, 1 month to 7.8 years). Informants were most often husbands (28%), older male relatives (26%), or co-wives (18%). Multivariate analysis indicated that the sex of the respondent, the respondent's presence in the village during the terminal phase of the woman's illness, and time after delivery were significantly associated with the risk of not reaching a specific diagnosis after a maternal death through verbal autopsy. Women were less likely than men to provide adequate information for a diagnosis (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.2-8.1). Respondents who did not reside in the village during the woman's illness or delivery carried equal risk of not reaching a conclusion (OR, 3.1; 95% CI, 1.1-9.1). Deaths occurring more than 1 week after delivery also were less likely to be classified (OR, 6.1; 95% CI, 1.7-22.0). The verbal autopsy method is both economical and technically feasible in areas where health workers have only minimal training in determining causes of death.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 141320.Article de périodique
Ferriman A.
Medical abortion still not available in most countries
1999 - Bmj, 319(7217), p. 1091
Mots clés : médicament; mortalité maternelle; avortement; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographiqueRésumé : Rates of unsafe and illegal abortion vary throughout the world, with rates of 0-4/1000 women in the US, western Europe, Australia, and China and rates of >25/1000 in the Soviet Union, Africa, Southeast Asia, and South America. Although thousands of women die from unsafe and illegal abortion annually, several countries still have no plans of adopting medical abortion. The introduction of the mifepristone pill in France in 1980 as a safe and effective method of abortion is limited to a minority of countries. Women who used the drug expressed their satisfaction, since 1) it seemed a natural way of having an abortion, 2) anesthesia is avoided, and 3) it is more compatible with their lifestyle. Complaints in using the drug include pain, bleeding, and uncertainty. The drug has a success rate of 98% in clinical trials in the US. .
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 146206.Article de périodique
Billings D.L.; Ankrah V.; Baird T.L.; Taylor J.E.; Ababio K.P.; Ntow S.
Midwives and comprehensive postabortion care in Ghana
1999 - 141-158
Mots clés : méthodologie; complication; traitement; soin; sage-femme; personnel de santé; soin post-abortum; service de santé; mesure; avortement; contraception d'urgence; contraception postcoitale; planning familial; éducation; personnel de santé; soin; santé; programme planning familial; santé de la reproduction
Pays / Régions : Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This operations research project examined a single strategy for minimizing the three delays in relation to emergency treatment for incomplete abortion in Ghana. These delays may occur in the following instances: making the decision to seek care; reaching a health care facility with providers trained and equipped to offer services; and receiving adequate treatment upon arrival at the facility. The purpose of the project was to train and equip registered midwives working at the primary level and in private maternity homes to deliver postabortion care. Using a quasi-experimental preintervention, postintervention design with nonrandomized intervention and control groups, the project demonstrated that postabortion care provided by trained midwives in the primary level facilities is feasible within the existing health care infrastructure in Ghana. It was noted that such care is acceptable to women, health care providers, community leaders, and policymakers. In addition, the training of primary level midwives has also improved access to postabortion care and facilitated the provision of postabortion family planning services for women treated for incomplete abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147374.Congrès
Thiriat M.P.
Nuptiality transition and first birth, Lome, TogoTransition de la nuptialite et premiere naissance Lome (Togo)
1999 - Conférence Africaine de Population : la Population Africaine au 21ème Siècle, Durban, UAPS, 213-225 p.
Mots clés : méthodologie; ville; résidence; déterminant fécondité; nuptialité; état matrimonial; mariage; mariage; état matrimonial; âge; naissance; avortement; population; facteur démographique; fécondité; grossesse; taux fécondité; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Togo; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Works on direct fertility determinants demonstrate the importance of nuptiality's contribution to fertility level. In a population which does not voluntarily limit its fertility and in which prenuptial fertility is negligible, an increase in women's mean age at first marriage reduces the overall period of potential childbearing. Reducing the period of time spent in union leads to reduced fertility. According to demographic transition theory, increased marriage age precedes voluntary reduction of marital fertility. The author examines the evolution of the relationship between age at first union and age at first birth in successive generations of Lome residents to identify which factors favor and impede the adoption of new behaviors. Among West African countries participating in the 1988 Demographic and Health Survey (DHS), Togo sets itself apart through major total fertility differential between urban and rural areas, 4.1 children in Lome compared to 6.9 children in rural areas. Using the biographical behavior approach, the author attempts to show, through 1988 DHS data on Togo, the dissociation observed in Lome between age at first union and age at first birth. Sexual activity accelerated nuptiality in older generations, but not among current younger individuals among whom older marriage age affects neither their sexuality nor reproductive behavior. Reduced fertility in Lome, a city of low contraceptive prevalence, results from couples' use of induced abortion to limit births.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 153491.Congrès
Yumkella F.
Nurse midwives role for the expansion of comprehensive post abortion care services : The case of Kenya and Uganda
1999 - Third African population conference, " the African Population in the 21st century", 6-10 December 1999, Durban, South Africa, UAPS/UEPA/NPU, 193-209 p.
Pays / Régions : KenyaRésumé : Le Kenya et l'Ouganda ont lancé un projet pilote pour tester les approches de vulgarisation des services de soins post-abortifs auprès des sages femmes impliquées dans ces services. Le projet kenyan porte sur les sages femmes travaillant dans le secteur privé tandis que le projet ougandais concerne les sages femmes du service public sous tutelle du ministère de la santé. Les deux projets bénéficient du soutien du projet PIME financé par l'USAID. Le projet kenyan a formé 57 sages femmes contre 24 pour l'Ouganda. Les résultats préliminaires présentés dans cette communication montrent que le projet est globalement satisfaisant. Les femmes ayant des complications dues à des avortements incomplets reçoivent plus systématiquement et plus rapidement des soins de bonne qualité. Grâce au projet, 210 aspirations intra-utérines manuelles ont été effectuées au Kenya en 11 semaines et 369 en Ouganda en 24 semaines. De plus, le projet a permis d'améliorer les services de conseil en planification familiale. Ces expériences du Kenya et de l'Ouganda pourraient être transposées dans l'avenir à d'autres pays africains avec profit étant donné que les avortements demeurent l'une des préoccupations majeures en santé de la reproduction en ce début du troisième millénaire (Résumé d'auteur)
Source : source Ceped : http://ceped.cirad.fr.Rapport
Guillaume A.
Planification familiale et pratique de l'avortement : une étude dans quatre FSU-Com d'Abidjan. Rapport d'enquête
1999 - ENSEA-IRD, Abidjan, 59Résumé : À partir d'enquêtes menées dans quatre centres de santé d'Abidjan auprès de consultants et de personnels de santé, cette étude présente une analyse de l'offre et de la demande de planification familiale, ainsi que la pratique de l'avortement par les femmes.Elle révèle une demande de maîtrise de la fécondité dans cette population abidjanaise, dans un but d'espacement comme de limitation des naissances. Les femmes ont dans l'ensemble une bonne connaissance de la contraception mais seulement 12 % utilisent une méthode moderne de contraception. Le manque d'information sur les méthodes est une des raisons expliquant la non utilisation de la contraception.La pratique de l'avortement est très répandue chez les femmes interrogées puisqu'un tiers d'entre elles en ont eu au moins un durant leur vie Elle tend à se développer dans les plus jeunes générations puisque ce recours s'intensifie aux jeunes âges et dès les premières grossesses. Une majorité des avortements sont faits dans un environnement médical, sans que l'on sache les conditions sanitaires réelles de cet acte, mais une part importante est pratiquée à domicile avec des méthodes traditionnelles, des pratiques à risque pour la santé des femmes. L'avortement contribue à une réduction de 10 % de la descendance des femmes, son impact sur la fécondité n'est donc pas négligeable.Les raisons du recours à l'avortement révèlent un besoin non satisfait de planification familiale et intervient comme mode de régulation de la fécondité. Ainsi il peut intervenir pour retarder son entrée en vie féconde, comme pratique d'espacement ou de limitation des naissances, parfois suite à l'échec d'une méthode contraceptive ou en remplacement de ces méthodes.
Source : Source Ceped : http://ceped.cirad.fr.Chapitre d'ouvrage
Mundigo A.I.; Shah I.H.
Policy Impact of Abortion Research
1999 - In A.I. Mundigo et C. Indriso (Eds.), Abortion in the developing world, p. 477-488. New Delhi: World Health OrganizationRésumé : Globally, abortion continues to be a very controversial issue; many and diverse points of view about it are argued in public debates. This paper provides case studies where social science research, conducted on the issue of induced abortion, has resulted in major impact for policy utilization. Moreover, it provides new light on what the reality of abortion means under different social, legal, and political contexts. It is noted that barriers to conducting research on induced abortion are many and range from institutional hostility to women's refusal to answer questions concerning the issue. However, findings obtained by the case studies indicate that induced abortion is not restricted to adolescents facing unwanted pregnancy but occurs equally within marriage to limit family size. It is also clear that induced abortion exists both in contexts where family planning programs are strong as well as where they are weak or nonexistent. In other contexts, where contraceptive choices are limited, abortion forms part of fertility regulation strategies that include a mix of traditional and modern methods, often used ineffectively. Unsafe clandestine abortions are more likely to be sought by poorer, less-educated women, and also by adolescents. The studies dealing with providers' perspectives point to the cost in both human and financial resources of treating abortion complications that drain hospital budgets unnecessarily.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156361.Article de périodique
Temin M.J.
Post-ICPD+5: Where do we go from here?
1999 - Reproductive Health Matters, 7(14), p. 158-163
Mots clés : politique; programmeRésumé : This yearmarked the five-year Review of the 1994 Intemational Conference on Population and Development in Cairo. This review allowed a refocusing of effort within the broader context of the Cairo Programme of Action. It revealed progress in some areas, but also some serious gaps. The international community has not provided effective leadership on some of the toughest health problems, norhave national governments taken on sensitive issues. The review indicated that governments must find ways to promote sexual and reproductive health within health sector reform and work more effectively with NGOs. It also highlighted the need to use existing knowledge to tackle the epidemic ofHIV/AIDS, young people's sexual and reproductive health problems, maternal mortality and morbidity, and unsafe abortion. Work on these issues requires leadership and coordination at national level, along with well coordinated international support for governments willing to take on these controversial topics. ICPD+5 will only have been worthwhile if the recommendations are sufficiently resourced and supported by action in a range of social sectors.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Buffington S.D.
Postabortion care programs: a global update
1999 - 31-41
Mots clés : soin post-abortum; complication; service de santé; éducation; programme planning familial; planning familial; contraception d'urgence; contraception postcoitale; soin; santé
Pays / Régions : Etats Unis; Afrique; Asie; Amérique Latine; Amérique du Nord; AmériqueRésumé : This document presents a global update on postabortion care (PAC) programs, which is a summary of the workshop proceedings on issues in the establishment of PAC services in low-resource settings. The PAC programs, which were initially implemented and designed in 1993, include emergency treatment of complications of spontaneous and unsafely induced abortion, provision of postabortion family planning, and other reproductive health services. Conclusions gathered at the meeting include: the need to build a common framework for PAC, a strategic plan on PAC services, better coordination of PAC programs, and collaboration on common advocacy strategies that emphasize the missions, country leaders, other donors and PAC programs. Several steps have been identified as the key elements of a comprehensive approach to PAC services involving the organization of services, communication, providers, policy and management. Various steps were emphasized as critical in the development of PAC program such as the development of common strategic approach, sharing of lessons learned, focus on fewer countries, address on sustainability and measurement of impact, increase success awareness, mobilization of human and financial resources, clarification of PAC roles and leadership, and collaboration with other donors.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 146800.Ouvrage
Huntington D.; Piet Pelon N.J.
Postabortion care: lessons from operations research
1999 - New York (US): Population Council, 218 p p.
Mots clés : service de santé; soin post-abortum; complication; contraception; méthode contraceptive; programme planning familial; avortement; soin; santé; santé de la reproduction; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Egypte; Kenya; Bolovie; Mexique; Ghana; Afrique du Nord; Afrique; Pays arabes; Pays Méditerranéens; Afrique de l'Est; Afrique Subsaharienne; Afrique Anglophone; Amérique du Sud; Amérique; Amérique Latine; Amérique du Nord; Afrique de l'OuestRésumé : Among the most neglected reproductive health care patients are women who have experienced complications from incomplete abortion. The medical care that is provided for these women are generally poor, with an unacceptable quality of communication and standards between health care providers and patients, as well as inappropriate referrals to family planning services following treatment. It was only recently that postabortion care became a priority in women's reproductive health programs. This book features a study that focus on how to reduce the number of death and morbidity associated with unsafe abortion. It describes operation research studies on postabortion care conducted in Africa, Latin America, and the Middle East. Chapter 2 presents the effect of husband involvement on postabortion recovery of patients and contraceptive use in Egypt, while chapter 3 reports on the association between incomplete abortion treatment and family planning services in Kenya. Chapters 4 and 5 present the service quality and contraceptive acceptance improvement in Bolivia and Mexico. Chapters 6-10 present a cost estimation of postabortion services in Mexico and Egypt, the role of midwives in a comprehensive postabortion care in Ghana, the roles of traditional midwives and postabortion care services in Mexico, and the ethical issues in postabortion care research.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147353.Article de périodique
Anonymous
Postabortion care: midwives expand service availability in Sub-Saharan Africa
1999 - 4
Mots clés : complication; mortalité maternelle; sage-femme; personnel de santé; programme; service de santé; soin post-abortum; traitement; soin; femme; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique; personnel de santé; soin; santé; programme planning familial
Pays / Régions : Ghana; Kenya; Ouganda; Afrique Subsaharienne; Afrique de l'Ouest; Afrique; Afrique Anglophone; Afrique de l'EstRésumé : This article highlights the expansion of the availability of midwives and postabortive care services in sub-Saharan Africa in response to the high rate of unsafe abortions. Unsafe abortions account for high levels of maternal mortality throughout the world. In Africa, the high rate of unsafe abortions is linked in part to the lack of access to contraception. Midwives are well positioned to be one of the first referral points for the majority of obstetrical emergency patients and to play a critical role in reducing maternal mortality and morbidity. It was suggested by the WHO, the UN Children s Emergency Fund, and the International Confederation of Midwives that midwives provide comprehensive postabortive care (PAC), including emergency treatment for abortive complications, postabortive family planning counseling and other reproductive health services. Acting on the potential of midwives providing PAC services, 3 countries in sub-Saharan Africa--Ghana, Kenya, and Uganda--are undertaking collaborative projects to design, implement and evaluate approaches to expand the availability of PAC services at the primary level facilities. Project results are expected to contribute to PAC expansion strategies in the 3 countries, to other countries in sub-Saharan Africa, and elsewhere in the world. Documentation of the approaches, policies, partnerships and service integration in Ghana, Kenya, and Uganda are presented.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 145585.Congrès
Mane B.; Dieng T.; Faye E.O.; Tapsoba P.; Mengue C.; Diadhiou F.
Prévention et prise en charge des complications de l'avortement incomplet au Sénégal : résultats d'une expérience pilote dans quatre structures sanitaires de référence de la région de Dakar
1999 - Troisième Conference Africaine de Population "La population Africaine au 21ème siècle", 6-10 décembre 1999, Durban, Afrique du Sud, UAPS/UEPA/NPU, 221-233 p.
Mots clés : complication; traitement; soin; soin; service de santé; programme planning familial; mortalité maternelle; contraception d'urgence; contraception postcoitale; planning familial; santé; programme; mortalité; population; facteur démographique
Pays / Régions : Sénégal; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : In Senegal, pregnancy- and delivery-related risks remain high among reproductive-aged women. The 1992/93 Demographic and Health Survey identified a maternal mortality rate of 510 deaths per 100,000 live births. According to World Health Organization estimates, abortion-related complications are responsible for 13-20% of maternal mortality in sub-Saharan Africa. A pilot program offering post-abortion care was implemented in four tertiary healthcare facilities in Dakar with the goal of reducing by 50% the prevalence of risky abortions and their complications in Senegal by 2001. An integrated approach was employed in which intrauterine manual aspiration was used as an alternative to dilatation and curettage, together with family planning services and referral to other patient services as needed. Main findings from this experience are presented on patients' profiles, abortion type and complications, the impact upon improving the quality of post-abortion care, post-abortion family planning, and the costs of post-abortion care. The introduction of norms and protocols through this program improved health facilities' clinical practices.French Abstract: Au Sénégal, les risques associés à la grossesse et à l'accouchement demeurent très élevés chez les femmes en âge de procréer. L'Enquête démographique et de santé de 1992/93 indiquait un taux de mortalité maternelle de 510 décès pour 100.000 naissances vivantes, dont les complications de l'avortement jouent un rôle important. Selon les estimations de l'Organisation Mondiale de la Santé, les avortements à risque sont responsables de 13 à 20% des décès maternels en Afrique subsaharienne. Dans la perspective de mettre en oeuvre une approche basée sur le concept de soins après avortement, destinée à réduire de 50% la prévalence des avortements à risque au Sénégal et de leurs complications par l'an 2001, une expérience pilote a été tentée dans quatre structures sanitaires de référence de la région de Dakar. L'expérience reposait sur l'introduction d'un modèle intégré incluant l'utilisation de la technique d'aspiration manuelle intra utérine comme alternative à l'ancienne technique de dilatation/curetage, les prestations de services planning familial, et la référence à d'autres services en vue de prendre charge des autres besoins des patientes. Les principales conclusions de cette expérience sont présentées à l'égard du profil des patientes concernées, du genre d'avortement et de complications, de l'impact du modèle sur l'amélioration de la qualité des soins après avortement, de la planification familiale post abortum, et des coûts des soins après avortement. Un acquis important de cette expérience pilote a été l'amélioration des pratiques cliniques des structures de santé du fait de l'introduction de normes et protocoles.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 154715.Article de périodique
Henshaw S.K.; Singh S.; Haas T.
Recent trends in Abortion rates wordwide
1999 - International Family Planning Perspectives, 25(1), p. 44-51
Mots clés : méthodologie; tendance; avortement; contraception d'urgence; contraception postcoitale; planning familialRésumé : This study examined trends in abortion among 54 countries with legal abortion or widely available abortion services. Data were obtained from national statistical offices and other sources for 1997. Findings indicate that abortion rates have declined sharply in formerly socialist countries in Central and Eastern Europe and Russian satellite countries. For example, in Kazakhstan, abortion declined during 1991-96 by 47%. During 1980-90, abortion rates declined in former Soviet states, in some cases well before the decline of Communism. Some states experienced an increase. European socialist states followed similar patterns. For example, in Poland, the abortion rate declined to almost zero. The former Yugoslavian states have also reduced their abortion rates. Abortion rates declined in many developed countries. Countries with declines include Denmark, Finland, France, Italy, Japan, the US, and Germany. Some developing countries had rising abortion rates. For example, in Viet Nam abortion incidence rose 6-fold during 1984-92. The former socialist countries now have greater availability of contraceptive services and supplies. Public awareness and understanding of contraception may account for abortion decline in developed countries. Increased contraceptive use decreases reliance on abortion. Legal abortion initially leads to increased abortion.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2504499.html.Article de périodique
Folsom M.
Regional Postabortion Care Initiative. Health networks: a regional approach to improving postabortion care in East and Southern Africa
1999 - 51-59
Mots clés : soin post-abortum; service de santé; avortement; programme; programme planning familial; planning familial; soin; santé; contraception d'urgence; contraception postcoitale
Pays / Régions : Afrique de l'Est; Afrique Australe; Afrique Subsaharienne; AfriqueRésumé : This paper illustrates how Regional Health Networks foster collaboration and improve postabortion care (PAC) in East and Southern Africa (ESA) with the use of field examples from the PAC Initiative. The PAC Initiative uses networking mechanisms to improve PAC in the ESA region. The following activities demonstrated the successful use of networking mechanisms: 1) development and distribution of advocacy materials and 2) country assessments which contributes to a growing regional perspective and knowledge base that is helping to inform the design and implementation of PAC programs throughout the region. Examples of country-initiated activities are: 1) a study tour in Ghana through the USAID-funded MotherCare Project, which trains midwives to improve PAC; 2) the Quality of Care component of Health Networks, which conducted a workshop on standards and guidelines in Harare, Zimbabwe; and 3) expanding opportunities for PAC in communities through private nurse/midwives in Kenya.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 146802.Article de périodique
Kamaara E.
Reproductive and sexual health problems of adolescent girls in Kenya: A challenge to the church
1999 - Reproductive Health Matters, 7(14), p. 130-133
Mots clés : santé de la reproduction; sexualité; contraception; méthode contraceptive; adolescence; adolescent
Pays / Régions : KenyaRésumé : Young women growing up in a poor country like Kenya face multiple discrimination on the basis of sex, age and economic status. Although pre-marital sex is condemned in nearly all societies, and young, unmarried people, especially young women, are not expected to be sexually active, the gap between expected and actual behaviour is enormous. In sub-Saharan Africa, the majority of young girls are sexually active, sometimes with multiple partners. Studies in sub-Saharan Africa indicate that youth are initiated into sexual activity as early as age 12 for girls and 13 for boys.1 It is also estimated that 62 per cent ofall mothers in sub-Saharan Africa are within the 15-19 age cohort.2 This results in reproductive health problems, including pregnancy, abortion, HIV infection and other sexually transmitted diseases and stress, which are of both policy and theological significance. The Church could take a lead in putting the reality of youth sexuality into the public consciousness and onto the political agenda. As the moral conscience of Kenyan society, the Church should condemn discrimination against adolescent girls and take positive action by initiating a youth pastoral ministry through which the reproductive health needs of adolescents might be addressed.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Bennett T.
Reproductive health in South Africa
1999 - Public Health Reports., 114(1), p. 88-90
Mots clés : santé de la reproduction; santé; loi; droit; genre; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This article discusses the state of reproductive health in South Africa. Before 1997, there were about 200,000 illegal abortions performed in South Africa annually; 45,000 of these procedures caused women to be hospitalized due to incomplete abortion, and more than 400 women died due to unsafe abortion each year. The choice of pregnancy termination was based on the Constitution giving them rights to reproductive choice and access to health care services, including reproductive health care. The South African Constitution also mandated the creation of a commission for gender equality in order to promote respect for gender equality and the protection, development, and attainment of gender equality. Moreover, on-going reproductive health projects of the country include research on maternal mortality, acceptability of female condom, emergency contraception, community-based prevention of human immunodeficiency virus infection, and the feasibility of patient-retained health cards.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 143426.Chapitre d'ouvrage
Mundigo A.I.
Research Methodology: Lessons Learnt
1999 - In A.I. Mundigo et C. Indriso (Eds.), Abortion in the developing world, p. 465-476. New Delhi: World Health OrganizationRésumé : The study of abortion behavior, especially its determinants and consequences, requires the utilization of exploratory research methods, often innovating or combining techniques derived from a variety of disciplines. This paper stresses the social and psychological dimensions of induced abortions, wherein, research designs are firmly anchored in the methodology of the social sciences. These research designs include quantitative, qualitative, and provider studies. Of the qualitative studies, anthropological techniques such as direct observation, in-depth interviewing utilizing interview guides, focus group discussion and subject focused one-on-one discussions are particularly well-suited to pursue difficult questions such as those that arise in abortion research. The studies that utilized quantitative approaches as their central technique for data collection are divided into hospital-based surveys, follow-up studies, community surveys, special group surveys, and national surveys. A final category, "provider studies," is another example of the mix approach. It requires separate discussion because of the special problems in first identifying and then interviewing abortion providers in countries where abortion is illegal. Overall, the increasing problem of teenage pregnancy requires further study, particularly when abortion is used to terminate unwanted pregnancies in contexts where the practice is unsafe. It is suggested that in the field of abortion research, assessment of different methodologies, alone or in combination, is essential to improve the validity and quality of data upon which findings are built.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156360.Article de périodique
Whitaker C.; Germain A.
Safe abortion in Africa: ending the silence and starting a movement
1999 - African Journal of Reproductive Health, 3(2), p. 7-10
Mots clés : loi; politique; grossesse non prévue; grossesse non désirée; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique
Pays / Régions : AfriqueRésumé : During the International Conference on Population and Development in 1994, unsafe abortion was considered as a major public health problem. The UN General Assembly conducted in 1999 reaffirmed the pledge to reduce unwanted pregnancy and death and suffering associated with unsafe abortion. Numerous women have suffered from unsafe abortion worldwide. An estimated 680 deaths per 100,000 abortions were reported among African women--the highest abortion-related death rate. Complications from unsafe abortion represent a significant portion of maternal mortality throughout the region, with an increase in risks among adolescent girls. In Nigeria, 60% of the complications treated in hospitals were in adolescent girls who had undergone unsafe abortion. Prevention of unsafe illegal abortion was to provide contraceptive services, including emergency contraception, but safe abortion was still deemed necessary. Several steps that would ensure the delivery and implementation of safe abortion include: 1) education of providers in abortion techniques; 2) information on law and accessibility of services through outreach and public education; 3) provision of humane treatment for women who have suffered complications from unsafe abortion; 4) development of a persuasive evidence for instituting legal, policy and program change; and 5) development of a broad-based coalition at local, national and international levels for concerted advocacy which includes both general public education and lobbying for legislative change.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147695.Chapitre d'ouvrage
Rance S.
Safe motherhood, Unsafe abortion: A reflection on the impact of Discourse
1999 - Safe motherhood initiatives: Critical issues, p. 73-84. London: Blacwell Science Limited For Reproductive Health Matters
Mots clés : mortalité maternelle; santé; avortement; santé de la reproduction; politique; programme; législation; mortalité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Bolovie; Amérique du Sud; Amérique; Amérique LatineRésumé : This article examines the impact of discourses on maternal mortality, including issues pertaining to induced abortion, health policies and services for women. In the 1987 International Conference on Safe Motherhood held in Nairobi, a goal was set to halve the number of maternal deaths in developing countries by the year 2000. Subsequently, efforts were made by the Bolivian government to rapidly reduce maternal mortality rates, at least one third of which result from the complications of unsafe abortions. Public debates increasingly centered on women's health and experiences have touched on the issue of abortion, however, opposition from conservative forces within the Bolivian government influenced by the Catholic hierarchy has curtailed such endeavors in 1996. Moralists addressed the government, as well as the general public, labeling abortion as criminal and anti-life. This scenario provides evidence that discourses, which condemn abortion, have material effects on women's bodies and lives. Hence, there should be recognition and consolidation of the advances brought about by the Safe Motherhood Initiatives and a revitalizing of these initiatives with new concepts and fresh objectives.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147662.Congrès
Mane B.; Ndiaye F.
Santé de la reproduction des adolescents au Sénégal : quelles stratégies?
1999 - La population africaine au 21e siècle (vol. 3)Conférence Africaine de Population : la Population Africaine au 21ème Siècle, 3, Durban (ZA) 1999/12/6-10, p. 177-189 p.
Mots clés : adolescence; adolescent
Pays / Régions : SénégalRésumé : Cette communication a pour objet de faire le point sur l'expérience du Sénégal dans le domaine de la santé reproductive des adolescent. Elle est basée sur les résultats des EDSI, EDSII et EDSIII du Sénégal. Après avoir décrit l'ampleur et la spécificité des problèmes de santé reproductive des adolescents, les auteurs ont ensuite procédé à l'examen des politiques et progrès initiés en vue de résoudre ces problèmes. Pour finir, ils ont tiré les leçons des expériences passées et proposé des solutions pour l'avenir (Résumé d'auteur)
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Hodonou K.A.; Adjahoto E.O.; Ekouevi Y.D.; Tete V.K.; Akpadza K.; Baeta S.
Sex behavior among studentsPratique de la sexualite en milieu scolaire
1999 - Contraception, Fertilite, Sexualite, 27(4), p. 313-317
Mots clés : adolescence; adolescent; étudiant; scolarisation; femme; sexualité; contraception; méthode contraceptive; avortement; jeune; adolescent; âge; population; facteur démographique; éducation; comportement; planning familial; contraception d'urgence; contraception postcoitale
Pays / Régions : Togo; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : 1867 female students from the lower and upper schools of 43 randomly selected educational institutions in the maritime and central regions of Togo completed anonymous questionnaires about their sexual behavior. The students ranged in age from 12 to 26 years and averaged 19. 1333 (72%) reported having had intercourse. First intercourse occurred at age 17 on average. 73% reported having coitus once a month or less frequently. Reported motivations for sexual activity were varied. 69% mentioned love and 8% mentioned money among their reasons. Information on the partner was provided in 618 cases. 59.5% were students, 33% were employed, and 7% were teachers. 418 of the 1333 sexually active students (31.3%) had been pregnant at least once. 87.5% of the pregnancies ended in induced abortion, 5.6% in spontaneous abortion, and 6.9% in childbirth. 1726 of the students (92.4%) reported knowing a contraceptive method and 604, or 45% of those sexually active, used a method. 560 used condoms, 81 spermicides, 369 the calendar method, 54 pills, 6 IUDs, 14 injectables, and 103 withdrawal.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 141646.Rapport
The Alan Guttmacher Institute
Sharing responsibility women society and abortion worldwide
1999 - The Alan Guttmacher Institute,, New York, 66
Mots clés : grossesse non prévue; grossesse non désirée; incidence; complication; risque; santé de la reproduction; fécondité; population; facteur démographique; mesure; méthodologie; contraception d'urgence; contraception postcoitale; maladie; complication; santé publique; santéRésumé : In order to inform the abortion debate with an increased understanding of why so many women worldwide undergo induced abortions and how societies can respond, this report offers the most reliable facts available about the determinants, levels, and consequences of induced abortion in many parts of the world. When considering abortion as a response to unplanned pregnancy, the report reviews: 1) what factors lead to unplanned pregnancy in developing and developed countries, 2) the prevalence of unplanned pregnancy, and 3) why women decide upon abortion. Data in this report focus on 15 developing and three developed countries. In its review of the status of induced abortion, the report looks at: 1) laws and regulations in countries with a population of a million or more; 2) the annual number of induced abortions, the proportions of women having abortions, and the characteristics of these women; 3) the relationship between legality and safety of abortion; 4) the quality and availability of abortion services in settings where it is legal; 5) the quality and availability of abortion services where it is severely restricted or prohibited; 6) the kinds of abortion practitioners and methods used to abort or self-abort in developing countries; and 7) the safety of modern abortion techniques and risks of abortions performed outside of medical settings. Finally, the report discusses what can be done to reduce levels of unplanned pregnancy and lessen the adverse effects of unsafe abortion. Additional data are provided in six appended tables (abstract Popline : PIP 141126)
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/sharing.html.Article de périodique
Henshaw S.K.; Singh S.; Taylor H.
Tendances récentes des taux d'avortements dans le Monde
1999 - Perspectives Internationales sur le Planning Familial, N° spécial de 1999(26-30
Mots clés : méthodologie; tendance; avortement; contraception d'urgence; contraception postcoitale; planning familialRésumé : Contexte: Les taux d'avortement légal varient largement dans les pays dotés de législations non restrictives. Les données relatives aux tendances de l'avortement légal pourraient éclairer les responsables politiques sur les facteurs d'influence des taux d'avortement légal et des taux envisageables dans leur pays et dans le reste du monde. Méthodes: Les nombres d'avortements légals ont été estimés, pour 54 pays, sur la base de statistiques officielles ou d'autres données nationales. Les taux d'avortement par millier de femmes âgées de 15 à 44 ans ont été calculés pour les années 1975 à 1996. Résultats: La tendance récente la plus frappante concerne un net déclin de l'incidence de l'avortement en Europe de l'Est et centrale et dans les états successeurs de l'Union soviétique. Ainsi, les taux ont baissé de 28% à 47% dans quatre anciens états soviétiques disposant de données assez complètes (Bélarus, Estonie, Kazakhstan et Lettonie), et de 18% à 65% dans six états dont les rapports sont moins complets. Des tendances comparables ont été observées en Bulgarie, en Hongrie, en République tchèque et en République slovaque. Les taux d'avortement semblent en baisse aussi dans plusieurs autres pays industrialisés: depuis 1975, ils ont chuté de 40% à 50% au Danemark, en Finlande, en Italie et au Japon. Seuls quelques rares pays industrialisés (dont le Canada, la Nouvelle-Zélande et l'Ecosse) présentent une hausse des taux au fil du temps. Dans les quelques pays en voie de développement disposant de données fiables, certains (Chine, Corée du Sud, Tunisie et Turquie) ont enregistré une baisse des taux d'avortement, tandis que d'autres (Cuba et Viet Nam, notamment) présentent plutôt une augmentation de ces taux. Conclusions: Dans les pays industrialisés à taux d'avortement élevés, le recours à l'avortement diminue rapidement, en général, lorsqu'un éventail de méthodes contraceptives devient largement disponible et que ces méthodes sont pratiquées de manière efficace. La légalisation de l'avortement et l'accès à des services prestataires ne conduisent pas, à long terme, à un recours accru à l'avortement comme méthode de limitation des naissances. Dans les pays industrialisés où ces conditions sont réunies, la tendance dominante des taux d'avortement est en fait à la baisse.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.guttmacher.org/pubs/journals/25fre02699.html.Article de périodique
Varkey S.J.; Fonn S.
Termination of pregnancy
1999 - South African Health Review, 357-368
Mots clés : revue littérature; loi; plaidoyer; avortement; contraception; méthode contraceptive; programme; contraception d'urgence; contraception postcoitale; planning familial; communication; service de santé
Pays / Régions : Afrique du Sud; Afrique Anglophone; Afrique; Afrique Australe; Afrique SubsaharienneRésumé : This is an article extracted from the first review conducted in South Africa of all research addressing the implementation of the Choice on Termination of Pregnancy Act No 92 of 1996. A systematic and detailed methodology was undertaken to identify published and on-going research. Of the 86 identified studies, 41 were reviewed, 13 were forthcoming studies, 3 were published but unavailable, 6 focused on the process of advocacy reform and 23 were excluded as they did not meet the inclusion criteria. A framework developed for the review looked at service and community factors affecting access of potential and current abortion service users. From the reviewed studies, this article provides information on what is known about women's access to abortion services, but excludes findings of clinical research, methodologies for abortion research and forthcoming studies. The article also identifies what information is still required in order to ensure that abortion services are available and accessible to all South African women. Details of the methodology and the remaining included studies are available from the Health Systems Trust and the Women's Health Project. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 173415.Article de périodique
Kulczycki A.
The abortion debate in the world arena
1999
Mots clés : revue littérature; avortement; religion; politique; programme; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Kenya; Mexique; Pologne; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Amérique du Nord; Amérique; Amérique Latine; Europe de l'Est; EuropeRésumé : This book compares, contrasts and links the abortion debate globally by using multiple sources of evidence, including a study involving 162 elite interviews. Particularly, it examines the emergence and construction of the abortion debate beyond the Western liberal democracies and how the Catholic Church, the most visible transnational actor in this dispute, engages this issue worldwide. Divided into five chapters, chapter 1 outlines the key dimensions to "the policy conundrum" posed by abortion, the scope and purpose of the study, the issues and themes with which it is concerned, as well as the reasons for looking at Kenya, Mexico and Poland, respectively. In addition, it addresses a range of shared underlying concerns with a focus on what is salient in each country and its wider region. A description of "the tyranny of silence", which is a characteristic of much of Africa is presented in chapter 2, while an explanation on how concerned parties are "negotiating a hidden reality" in order to seek alternative ways out of this situation is discussed in chapter 3. Chapter 4 shows how and why conflict over abortion at times upstaged the whole process of systemic transformation as political theater in Poland and East Central Europe. Finally, chapter 5 reviews the main findings and examines a number of major themes, which weave through the study. It provides a more focused comparison between the three countries and their regions, set within a broader international context.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150841.Article de périodique
Mensch B.S.; Bagah D.; Binka F.
The Changing Nature of Adolescence in the Kassena-Nankana District of Northern Ghana
1999 - Studies in Family Planning, 30(2), p. 120-124.Résumé : This study reports the results of a primarily qualitative investigation of adolescent reproductive behavior in the Kassena-Nankana District, an isolated rural area in northern Ghana, where traditional patterns of marriage, family formation, and social organization persist. The study is based on in-depth interviews and focus-group discussions with adolescents, parents, chiefs, traditional leaders, youth leaders, and health workers, supplemented by quantitative data from the 1996 wave of a panel survey of women of reproductive age conducted by the Navrongo Health Research Centre. The social environment that adolescent boys and girls in the Kassena-Nankana District encounter and its links to reproductive behavior are described. The principal question is whether even in this remote rural area, the social environment has been altered in ways that have undermined traditional sexual and reproductive patterns. The survey data indicate a considerable increase in girls' education and the beginning of a decline in the incidence of early marriage. The qualitative data suggest that social institutions, systems, and practices such as female circumcision that previously structured the lives of adolescent boys and girls have eroded, leading to an apparent increase in premarital sexual activity.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 141313.Chapitre d'ouvrage
Zamudio L.; Rubiano N.; Wartenberg L.
The Incidence and Social and Demographic Characteristics of abortion in Colombia
1999 - In A.I. Mundigo et C. Indriso (Eds.), Abortion in the developing world., p. 407-446. New Delhi: World Health Organization
Mots clés : méthodologie; demande; grossesse non prévue; grossesse non désirée; avortement; facteur socio-économique; culture; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; facteur économique
Pays / Régions : Amérique du Sud; Amérique; Amérique LatineRésumé : This study examines the incidence of and circumstances surrounding induced abortion in Colombia. Quantitative and qualitative methods are applied to analyze key determinants of why urban women undergo abortion. Of all the abortions reported, 14.8% were among adolescents 15-17 years old, and a third were among women under 20 years of age. In the lower socioeconomic level 31.1% of abortions were among single women; in the upper classes, 54.6% were among single women. 78.4% of all abortions were the result of unintended pregnancy due to non-use of contraception. 21.6% were due to contraceptive failure or misuse. It is hoped that the findings will help to delineate policy actions and preventive strategies that will lower induced abortions in the country.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 156358.Article de périodique
Henshaw S.K.; Singh S.; Haas T.
The incidence of Abortion wordwide
1999 - International Family Planning Perspectives, 25((supplement)), p. S30-S38
Mots clés : méthodologie; taux; avortement; contraception d'urgence; contraception postcoitale; planning familialRésumé : This study relied on national official sources on legal abortions to estimate the incidence of induced abortion in 57 countries in 1996. The World Health Organization (WHO) provided data on illegal abortions. The data reflect a variety of sources and degrees of underreporting. Findings indicate that about 46 million abortions were performed worldwide in 1995. About 26 million were legal; 20 million were illegal. The abortion rate was about 35/1000 women aged 15-44 years. Legal abortions appear to have declined since 1987; illegal abortions have increased. WHO estimates that unsafe abortions rose from 3.7 to 5.0 million during 1990-95 in Africa. Most illegal abortions occur in Africa and Central and South America. Most legal abortions are performed in Europe. 64% of legal and 95% of illegal abortions are performed in developing countries. The legal and illegal abortion rate is 39/1000 women aged 15-44 years in developed countries and 34/1000 in developing countries. Abortions per 100 pregnancies are higher in developed countries. Central and Eastern Europe have very high abortion rates. Asia (59% of total abortions) has the largest total number of abortions. North America has only 3% of abortions. The subregion abortion rate is highest in Eastern Europe (90/1000). Countries with high abortion rates include Viet Nam, Romania, and Cuba. Russia and Romania have the highest recorded proportions of pregnancies that end in abortion (63%). 25% of 180 million pregnancies globally are resolved by abortion each year. Mistimed and unwanted pregnancies and contraception deficits are the main causes.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/25s3099.html.Chapitre d'ouvrage
Oodit G.; Bhowon U.
The use of induced abortion in Mauritius: an alternative to fertility regulation or an emergency procedure?
1999 - In A.I. Mundigo et C. Indriso (Eds.), Abortion in the developing world, p. 151-166. New Delhi: WHO
Mots clés : méthodologie; enquête; loi; taux; contraception; méthode contraceptive; avortement; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement
Pays / Régions : Maurice; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Afrique FrancophoneRésumé : In Mauritius, where induced abortion is illegal under any circumstances yet frequent, a study was conducted to assist policy makers in the formulation of policies and programs for the elimination of unsafe abortion and for more effective utilization of family planning services. Interviews were conducted among clinic staff and 475 women patients seeking treatment for abortion complications in three participating government hospitals. Data gathered from these samples were compared with the data obtained in the 1991 Contraceptive Prevalence Survey (CPS), which measured the level of contraceptive prevalence, method mix, and sources of contraception. The women in the study sample were younger, had fewer children, were less well-educated, and constituted a higher percentage of Creoles than the general population represented by the CPS data. They combined a high desire for not having a child with a relatively poor utilization of reliable family planning methods. These women used a safe, medical means of abortion in only a small number of cases, indicating poor knowledge of appropriate abortion methods and inadequate finances to pay the doctors' fees. Consequently, the abortion process was a horrendous experience that involved the use of the crudest methods, hospitalization and perhaps long-term negative consequences. The study subjects were observed to have negative perceptions of family planning methods, indicating their lack of connection with the service system. Moreover, the socioeconomic structure of Mauritian society is a major factor in why the study sample terminated their pregnancies. Based on these results, recommendations for future action are presented.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 156344.Article de périodique
Rogo K.O.
Urgent need to prevent abortion-related maternal deaths in Africa
1999 - East African Medical Journal, 76(10), p. 539-540
Mots clés : mortalité maternelle; grossesse non prévue; grossesse non désirée; complication; mortalité; population; facteur démographique; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : AfriqueRésumé : In regions where contraceptive prevalence is lowest and consequently unwanted pregnancies are highest, such as Africa, unsafe abortion and its ill consequences are prevalent. Abortion is estimated to account for a staggering 30-50% of annual maternal mortality in the region. The 1994 International Conference on Population and Development urged all organizations to strengthen their commitment to women's health, to deal with the impact of unsafe abortion as a major public concern, and to reduce the recourse to abortion through expanded and improved family planning services. Within this plan of action, prevention of pregnancy is of the highest priority; abortion should be safe in cases where it is legal; and, in all cases, women should have access to quality services for the management of complications arising from abortion. Reducing unsafe abortion is very feasible as it is within the capability of every society to reduce unplanned pregnancy and abortion. This can only be achieved if it is anchored in the belief that each woman has the right to control her own sexuality, fertility, health and well-being. The challenge for health professionals is to put in place appropriate policy and program responses that will save women from these very preventable deaths.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 150925.Article de périodique
Obed S.A.; Wilson J.B.
Uterine perforation from induced abortion at Korle Bu Teaching Hospital, Accra, Ghana: a five year review
1999 - West Afr J Med, 18(4), p. 286-289.
Mots clés : mortalité maternelle; morbidité
Pays / Régions : GhanaRésumé : A total of 79 cases of perforated uterus from termination of pregnancy in Accra, an incidence of 3.6% of induced abortion were managed at Korle Bu Teaching Hospital during the period 1990-1994.
Source : source West Afr J Med.Article de périodique
Abdel Moneim M.E.
Vaginal misoprostol alone for medical evacuation of missed abortion
1999 - Egyptian Society of Obstetrics and Gynecology, 25(1-3), p. 123-134
Mots clés : méthodologie; enquête; médicament; échec; traitement; soin; Misoprostol; méthode; étudiant; scolarisation; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : This study aims to evaluate the treatment efficacy for women with early missed abortion, up to 8 weeks, by vaginal administration of misoprostol alone, 200 mcg tablets and repeated every 4 hours to a total dose of 800 mcg or expulsion of gestational sac. This prospective observational study was conducted at Galaa Maternity Teaching Hospital, Cairo among 43 women with the diagnosis of missed abortion up to 8 weeks by ultrasound or physical examination. Complete uterine abortion occurred in 31 patients (72%). Failed medical treatment occurred in 12 women (28%). 15 patients (35%) needed dilatation and curettage for retained products of conception. Three patients required curettage for profuse bleeding after complete expulsion of contents. The mean induction to abortion time was 7.44 hours and the mean dose of misoprostol needed was 560 mcg. 27 patients (62%) were accepting misoprostol as medical treatment for missed abortion. There were no febrile complications and no untoward side effects. Therefore, there is a place for managing missed abortion medically without resort to surgery or anesthesia. Misoprostol is a cheap, effective and safe mode of treatment. Even when it fails to induce complete abortion it will induce cervical priming before resorting to surgery, so reducing the incidence of complications. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 163803.Rapport
United Nations; Population Division
World abortion policies 1999
1999 - U. Nations, New York,Résumé : The country reports of national policies concerning induced abortion in different countries
Source : source : United Nations.Article de périodique
Cisse C.T.; Faye E.O.; Cisse M.L.; Kouedou D.; Diadhiou F.
[Uterine perforation after an illegal abortion]
1999 - Med Trop, 59(4), p. 371-374
Pays / Régions : SénégalRésumé : This study focuses on problems related to the management of peritonitis following non-medically assisted abortions in developing countries
Source : source : Med Trop.
1997Article de périodique
Agadjanian V.
"Quasi-legal" abortion services in a sub-Saharan setting: users' profile and motivations
1998 - International Family Planning Perspectives, 24(3), p. 111-116
Mots clés : méthodologie; enquête; demande; grossesse non prévue; grossesse non désirée; avortement; hôpital; hospitalisation; ville; résidence; facteur socio-économique; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; psychologie; facteur psychologique; comportement; service de santé; soin; santé; facteur économique
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : This study provides a profile of 394 urban women seeking an abortion at Maputo Central Hospital in Mozambique, during May-July 1993. Interviews were conducted at admission. Mozambique was selected as a study site because of its quasi-legal abortion services. Mozambique has the most liberal de facto systems of abortion on request in sub-Saharan Africa. Findings indicate that 59% of abortion patients were single; 42% were in a union; and 3% were widowed, separated, or divorced. 23% were White or mixed race, while only 9% of Maputo's population were White or mixed race. 40% had no previous births. Women's ages ranged from 14 to 42 years. 13% were teenagers, 62% were in their 20s, and 25% were aged over 30 years. Studies of clandestine abortion indicate a higher proportion of adolescent abortion patients and a smaller proportion in a union. An estimated 10% of abortion patients were Muslims, compared to only 3% in the city population. 55% were natives of Maputo. 22% were born in other large cities. 62% of abortion patients lived in Urban District 1 or center-city, while only 18% of city population lived in this district. 36% were students, and 35% worked outside the home. 88% were white collar workers. 1 in 5 married women discussed the abortion decision with a partner. Material difficulties were the most commonly given reason for the abortion (41% of women), followed by desire for education (30% of women). Other reasons were child spacing (18%) and a stop to childbearing (15%). 6% cited poor health and 4% cited marital problems. Socioeconomic factors appear to be important in abortion choices.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2411198.html.Article de périodique
Rahman A.; Katzive L.; Henshaw S.K.
A global review of laws on induced abortion, 1985-1997
1998 - International Family Planning Perspectives, 24(2), p. 56-64
Mots clés : législation; loi; contraception d'urgence; contraception postcoitale; planning familialRésumé : This article provides a brief summary of abortion laws in 152 nations and dependent territories with populations of at least a million and documents changes in these laws since 1985. Classification of abortion laws according to level of restrictiveness (to save the mother's life, to preserve the mother's physical health, to safeguard her mental health, on socioeconomic grounds, and without restriction as to reason) reveals that 41% of the world's population lives in the 49 countries that allow abortion without restriction as to reason. The article then reviews the prevalence of other legal restrictions, such as gestational age, third-party authorization, type of medical facility and personnel, mandatory counseling requirements, restrictions on information, and fees. The review of trends since 1985 shows that 19 countries have reduced restrictions on abortion, and only one country has increased restrictions. This review provides regional summaries and also notes important changes in individual countries. The final section of the article covers factors that affect abortion availability, such as varying interpretations of laws, enforcement, the attitude of medical staff, and responses to the efforts of anti-abortion groups. It is concluded that most of the world's women live in countries where abortion is legal under many circumstances and that the global trend toward liberalizing abortion laws has continued and has enhanced the availability of safe abortion services.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2405698.html.Article de périodique
Bernstein P.S.; Rosenfield A.
Abortion and maternal health
1998 - International Journal of Gynecology Obstetrics, 63(sup 1), p. S115-S122
Mots clés : santé de la reproduction; femme; santé; complication; facteur politique; contraception d'urgence; contraception postcoitale; planning familialRésumé : Regardless of the legal, cultural, or religious status of abortion, women throughout history have terminated unwanted pregnancies and will continue to do so, even at great risk to their health and well-being. There is no issue that is less likely to be resolved in the foreseeable future than abortion. The concern must be whether abortion is safe or unsafe, which, in most cases, equates with legal status. Easy access to comprehensive family planning and reproductive health services is essential, to reduce the need for pregnancy terminations in countries where the procedure is legal and to enable the early recognition and treatment of abortion-related complications in countries where it is not. Even in countries where abortion is legal, the community of obstetricians and gynecologists has failed to play a strong leadership or advocacy role in this crucial component of maternal health care.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 140555.Article de périodique
Mpangile G.S.; Leshabari M.T.; Kaaya S.; Kihwele D.J.
Abortion and unmet need for contraception in Tanzania -- the role of male partners in teenage induced abortion in Dar es Salaam
1998 - African Journal of Reproductive Health, 2(2), p. 108-121
Mots clés : méthodologie; enquête; adolescence; adolescent; grossesse adolescente; grossesse; complication; demande; décision; sexualité; contraception; méthode contraceptive; étudiant; scolarisation; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial; comportement
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The reactions of male partners to an unwanted adolescent pregnancy and the role these men played in helping their partner to obtain an induced abortion were investigated in interviews conducted with 150 teenagers (mean age, 17.5 years) admitted to four hospitals in Dar Es Salaam, Tanzania, in 1991-92 with abortion complications. 44.8% of these teens were not aware of a single contraceptive method and only 18% were using contraception--primarily ineffective methods such as rhythm (6%). 44.4% of respondents considered abortion as soon as they learned they were pregnant. 60.8% reported they had conceived with a steady boyfriend and, at the time of interview, 52% remained in an ongoing relationship with their male partner. Less than 10% reported their male partner was a teenager and 31% attributed their pregnancy to a man over 45 years of age. 27% of teenage girls did not inform the man responsible about the pregnancy, while another 46% confided first in their male partner. Among teenage girls in the latter group, 62.3% were advised by their male partner to abort, 15.9% were urged to carry the pregnancy to term, and 17% of partners showed no interest and gave no suggestions. Only 31% of girls reported their male partner was instrumental in locating an abortionist. Close relatives, friends, neighbors, and work colleagues were more likely to be sources of information. On the other hand, 47.6% of male partners were prepared to pay the abortionist's fee. Finally, only 16.9% of male partners advised or helped the girl to seek hospital treatment when abortion-related complications occur. These results suggest several areas of grave concern, including the large unmet need for contraceptive information and supplies among female adolescents and the probable sexual exploitation of female teens by older men.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 137806.Article de périodique
Guttmacher S.; Kapadia F.; Naude J.T.; de Pinho H.
Abortion reform in South Africa: a case study of the 1996 Choice on Termination of Pregnancy Act
1998 - International Family Planning Perspectives, 24(4), p. 191-194
Mots clés : législation; loi; soin; politique; programme; planning familial; contraception d'urgence; contraception postcoitale; santé
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This article on abortion reform in South Africa opens by describing the racist population policies of the government during apartheid and noting that prior to 1975 common law permitted abortion if pregnancy threatened a women's mental well-being. Well-to-do White women had many abortion options, but women of color often had to resort to clandestine abortions or attempted self-abortions. The article then reviews how the medical establishment and women's groups sought to expand options for legal abortion in a climate dominated by fears of population stagnation among Whites. The resulting 1975 Abortion and Sterilization Act actually made it more difficult to obtain an abortion while appearing to increase the circumstances under which abortion was permitted. The article continues by discussing how this act failed as a health policy (reviewing the methods and costs of treating incomplete abortions in public-sector hospitals) and regional variation in the incidence of complications of abortion. Next, the article explains that access to legal abortion was an essential part of the health program drafted by the African National Congress during the 1994 elections but that the 1997 Choice on Termination of Pregnancy Act was passed only after a struggle. The article outlines the stipulations of the Act and identifies outreach, provider education, accessibility and availability, and monitoring of implementation as vital to the ability of the new Act to improve reproductive health. The conclusion notes that despite continuing implementation challenges, approximately 30,000 women obtained legal abortion in the first year of the Act, and the number of women experiencing complications or death from incomplete abortion decreased significantly.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2419198.html.Rapport
Anderson D.
Abortion, women's health and fertility
1998 - IUSSP, Liége, 21
Mots clés : fécondité
Source : Source : Ceped.Article de périodique
Anonymous
Africa's unsafe abortions
1998 - Africa Health, 21(1), p. 43
Mots clés : complication; mortalité maternelle; sage-femme; personnel de santé; aspiration; méthode; complication grossesse; maladie; complication; mortalité; population; facteur démographique; personnel de santé; soin; santé; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique; Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique AnglophoneRésumé : The World Health Organization (WHO) estimates that the death rate from unsafe abortion in Africa is 110/100,000 live births, the highest in the world. In the US, the death rate from abortion is 0.6/100,000. The WHO has concluded that reducing unwanted pregnancies in Africa would dramatically reduce the number of deaths from unsafe abortion. Death from unsafe abortion is the easiest to prevent and treat of all of the causes of maternal mortality. In Ghana, complications of unsafe abortion are the primary causes of death among women of reproductive age, claiming approximately 1200 each year. In response, the government is training community-based midwives to use manual vacuum aspiration to clear the uterus of fetal remains after a woman has a spontaneous miscarriage or unsafe abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 140994.Article de périodique
Lane S.D.; Jok J.M.; El Mouelhy M.T.
Buying safety: the economics of reproductive risk and abortion in Egypt
1998 - Social Science and Medicine, 47(8), p. 1089-1099
Mots clés : méthodologie; loi; demande; risque; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé publique; santé
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : Women in Egypt are legally permitted to have an induced abortion only when two physicians certify that the pregnancy presents a danger to the health or life of the mother. However, despite this legislated restriction, the available data indicate that abortion is widely practiced in the country. Legal, religious, economic, and health care policy influence the debate of and access to abortion in Egypt. Interviews were conducted with 18 Egyptian women in the Cairo area who sought abortions, 16 of whom were married and 17 of whom were Muslim. Altogether, the women had sought to induce a total of 26 abortions, of which 7 were induced by indigenous means and 15 were performed by physicians, for a total of 22 completed procedures. The women described the existence and use of a wide range of abortion methods which varied in safety and cost. The following approaches to induced abortion were identified in ascending order of safety, going from the least to most safe: indigenous methods, biomedical abortions at clandestine clinics, and biomedical abortions provided by private gynecologists. While wealthy women have the funds with which to buy the most safe, gynecologist-provided abortions, poor women must resort to the less safe abortion providers and methods.
Source : Source : Social Science Medicine.Article de périodique
Nawar L.; Huntington D.; Naguib M.
Cost-effectiveness of postabortion services in Egypt
1998
Mots clés : méthodologie; soin post-abortum; coût; soin; aspiration; méthode; programme; programme planning familial; planning familial; évaluation; santé; service de santé; facteur économique; population; facteur démographique; traitement; soin; avortement; contraception d'urgence; contraception postcoitale
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : In Egypt, where legal abortion is limited to cases when a pregnancy endangers the mother's life, a 1994 pilot study improved postabortion care in two hospitals through introduction of the manual vacuum aspiration (MVA) method under local anesthesia, which was accompanied by intensive training and follow-up monitoring as well as by strengthening of infection control and counseling, including referral for family planning. The positive results of this study led to government approval of a comprehensive program to improve postabortion care and to expansion to 10 hospitals. This paper reports on a pre/post-test study of the cost-effectiveness of the adoption of MVA and improved quality of care at two hospitals. Data were gathered on treatment cost, in terms of human resources and drugs, and on overhead costs. It was found that the cost of materials and medicines substantially increased in the post-test, largely due to the use of disposable cannulas. The cost associated with time hospitalized, however, declined in the post-test. It is concluded that costs can be further minimized by reviewing patient discharge protocols to reduce patient time hospitalized, conducting the MVA in treatment rooms rather than in operating rooms, training staff to reduce inefficiencies, and sterilizing cannulas for re-use.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 134117.Article de périodique
Solo J.; Ominde A.; Makumi M.; Billings D.L.; Aloo Obunga C.
Creating linkages between incomplete abortion treatment and family planning services in Kenya: what works best?
1998
Mots clés : programme; enquête; traitement; soin; complication; échec; service de santé; programme planning familial; étudiant; scolarisation; méthodologie; contraception d'urgence; contraception postcoitale; planning familial; soin; santé
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This study tested three different ways to improve postabortion care (PAC) at six hospitals in Kenya. The focus was on improving emergency treatment through the introduction or upgrading of manual vacuum aspiration (MVA) techniques. In Model 1, family planning (FP) services were provided on the gynecology ward by gynecology ward staff. In Model 2, FP services were provided on the gynecology ward by maternal-child health services and FP (MCH-FP) staff. In Model 3, services were provided in MCH-FP clinics by MCH-FP staff. Data were obtained from 319 incomplete abortion patients, 106 provider staff, and 92 male partners of patients during February-March and June-July of 1996. Other data were obtained from logbook reviews, questionnaires from medical superintendents and hospital matrons, cost study worksheets, and daily logs of researchers. The intervention included training in MVA and postabortion FP, provision of equipment and supplies, and reorganization of services. The evaluation was conducted during March-May 1997. Findings indicate that, on average, 35% of gynecological ward admissions were for incomplete abortions. The demographic and reproductive profile of patients was the same as pre- and post-intervention. Most provider interviews were with nurses. MVA treatment increased pre- and post-intervention. Duration of stay was reduced. Providers had more positive attitudes post-intervention. Pain control remained a problem. Model 1 was the most effective in provision of FP counseling. Model 3 had the highest quality of care.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 131274.Article de périodique
Le Coeur S.; Pictet G.; M'Pele P.; Lallemant M.
Direct estimation of maternal mortality in Africa
1998 - Lancet, 352(9139), p. 1525-1526
Mots clés : méthodologie; mortalité maternelle; taux mortalité; décès; avortement; santé de la reproduction; mortalité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; santé
Pays / Régions : Congo; Afrique Centrale; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Direct estimation of maternal mortality is facilitated in Brazzaville, Congo, by a law requiring that all bodies be delivered to a mortuary before burial. The authors investigated all bodies handled by the city's 3 mortuaries in a 4-week period in 1996. 15 maternal deaths were identified among the 138 female adult bodies. Based on the number of live births (27,888) in a 12-month period in 1995-96 and on the age distribution of the mothers, a maternal mortality rate of 645/100,000 was calculated. The lifetime risk for maternal mortality was estimated as 1 in 25 women. This rate is unexpectedly high since 90% of women in Brazzaville have access to prenatal care and most births occur in maternity hospitals. The excess maternal mortality is attributable, in part, to the high number of abortion-related deaths in young women. In this series, 6 deaths were due to abortion-related septicemia or hemorrhage. Maternal mortality is unlikely to decrease in African cities until more safe reproductive choices are available.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 138071.Rapport
Koffi N.G.
Étude socio-démographique et de planification familiale dans la commune de Tanda, avril 1994.
1998 - Études et recherches, n°24., ENSEA, Abidjan, 99
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Ene E.N.
Family planning, fertility control and the law in Nigeria -- the choices for a new century
1998 - African Journal of Reproductive Health, 2(2), p. 82-95
Mots clés : législation; contraception; méthode contraceptive; planning familial; loi; santé de la reproduction; politique; programme; population; droit; contraception d'urgence; contraception postcoitale; santé
Pays / Régions : Nigeria; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This analysis of the laws regulating fertility in Nigeria and the impact of these laws on women's human rights 1) describes the state of Nigeria's reproductive health policies and laws, 2) examines whether these laws hinder or encourage family planning (FP), and 3) proposes an action agenda for the next century. The first part of the article examines the laws regulating contraception and abortion in light of stated governmental population control policy. This section concludes that the law tacitly allows the use of invasive contraception and the provision of information about its use but that abortion is severely restricted and penalized and is only allowed to save a mother's life. Part 2 analyzes the law and explains how the government has been unable to meet its policy goals because it has failed to follow-up these goals with appropriate laws and actions. This part also delineates areas in which Nigeria's laws, especially the current laws on abortion, may conflict with guarantees provided in the Nigerian Constitution. The third part of the article recommends that the government 1) create clear, unequivocal laws regulating access to, use of, and education about contraception; 2) liberalize abortion laws; 3) establish regulations covering contraception and abortion service provision; 4) consider the needs of youth when making law and policy; 5) immediately integrate FP and contraceptive use into primary health care and subsidize costs; and 6) develop long-term strategies to help people make fertility control choices.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 138168.Article de périodique
Desgrées du Loû A.; Msellati P.; Ramon R.; Noba V.; Viho I.; Dabis F.; Mandelbrot L.; Welffens Ekra C.
HIV-1 infection and reproductive history: a retrospective study among pregnant women, Abidjan, Cote d'Ivoire, 1995-1996
1998 - International Journal of Std and Aids, 9(8), p. 452-456
Mots clés : méthodologie; VIH; sida; grossesse; histoire des naissances; fécondité; histoire; maladie; maladie; complication; population; facteur démographique; taux fécondité; fécondité; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Cote d'Ivoire; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Data were used from an observational study conducted in 1995 and 1996 in two antenatal care centers in the district of Yopougon, Abidjan, to determine the differences of fertility between HIV-1-infected and uninfected women in Abidjan, Cote d'Ivoire. Fertility indicators were built from retrospective data on pregnancies and births, and univariate and multivariate analyses were performed upon the indicators and stratified by age groups to compare HIV-1-positive and HIV-negative populations. 12.1% of 4396 women tested for infection with HIV were found to be infected with HIV-1. HIV-positive women had significantly fewer pregnancies than HIV-negative women aged 25-29 and 30-34 years. The risk of having had at least 1 abortion or stillbirth was significantly higher for HIV-1-infected women than for HIV negatives, when controlling for social and demographic factors. Study findings suggest that HIV-1 infection has adverse consequences upon female fertility, with lower fertility rates and more frequent adverse pregnancy outcomes. Family planning and antenatal care services should consider antenatal HIV counseling and testing among women in areas of high HIV prevalence.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 136423.Article de périodique
King T.; Benson J.
Hospitals reduce costs by improving postabortion care
1998 - Operations Research Alternatives, 8-10
Mots clés : soin post-abortum; complication; coût; programme planning familial; planning familial; avortement; contraception d'urgence; contraception postcoitale; intervention chirurgicale; méthode; intervention chirurgicale
Pays / Régions : Afrique; Amérique LatineRésumé : A cost study methodology developed by Ipas was implemented among 400 women presenting with incomplete abortion in 6 African and Latin American countries. The 23 studies involved observation of postabortion care services provided to women and documented the amount of time spent with providers and the costs of supplies and medications used during the treatment and recovery. Overall, results suggest that women treated with manual vacuum aspiration (MVA) (n = 213) had a one-third lower average length of stay compared to women treated with dilatation and curettage (DC) (n = 210). The median cost of treating incomplete abortion per patient was US$78.81 for DC and US$8.50 for MVA patients (89% lower median costs for women treated with MVA). A subset of analysis of the 9 pre- and post-intervention studies (n = 248) showed that switching to MVA significantly reduced the average length of stay from 36 to 15 hours per patient. Generally, researchers found that the bulk of postabortion care costs, regardless of whether MVA or DC was used, could be attributed to salaries and costs associated with in-patient, overnight stays. It is also noted that MVA training and reorganization of services has improved the quality of postabortion care while reducing resource use and costs.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 160229.Article de périodique
Anonymous
Identifying unmet need for postabortion care
1998
Mots clés : complication; traitement; soin; soin post-abortum; demande; programme planning familial; avortement; contraception d'urgence; contraception postcoitale; planning familial; facteur économique
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Hospital-based studies in Nairobi have shown that unsafely induced abortion accounts for as much as 35% of pregnancy-related mortality and at least 50% of hospitals' gynecological admissions. Consequently, a collaborative project is being conducted to test three different models linking emergency treatment of incomplete abortion and family planning (FP) services in six Ministry of Health hospitals. Study methodology includes collecting pre-intervention data; carrying out an intervention consisting of training, facility upgrades, and reorganization of services; and collecting post-intervention data. Researchers interviewed 481 patients and 140 staff at the selected hospitals to establish an understanding of the existing treatment of women admitted for postabortion complications. Overall, this diagnostic study shows a largely unmet need for more comprehensive services and scope for improvement in the quality of care provided. Such results were used during a 2-day joint planning workshop for implementation of the comprehensive postabortion care models to be tested at each hospital.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 159894.Article de périodique
Thomas L.M.
Imperial concerns and "women's affairs": state efforts to regulate clitoridectomy and eradicate abortion in Meru, Kenya, c. 1910-1950
1998 - Journal of African History, 39(121-145
Mots clés : enquête; législation; excision; avortement; loi; histoire; genre; facteur politique; grossesse prémaritale; sexualité premaritale; femme; contraception d'urgence; contraception postcoitale; planning familial; politique; santé de la reproduction; fécondité; population; facteur démographique; sexualité; comportement; facteur socio-économique; facteur économique
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This paper analyzes campaigns to regulate clitoridectomy and eradicate abortion in Kenya during the colonial period, revealing the contradictory and gendered nature of the colonial state's attempt to comply with the "moral obligations" of imperial rule while securing local political control. The paper reviews administrative concerns and knowledge during the period 1910-28, describes the initiation practices through the lens of local remembrance and ethnographic fragments, and reviews colonial opposition to clitoridectomy and abortion. The "female circumcision controversy" peaked in 1929-31 when missionaries gained support for a ban on the more severe forms of excision but failed to have this ban written into the 1930 penal code. The paper then looks at attempts of Local Native Councils to regulate clitoridectomy during the period 1925-34 and at attempts during 1929-51 to eradicate abortion by lowering the age of female initiation, reducing the time when an uncircumcised girl could engage in premarital sexual activity and risk an unacceptable pregnancy that would end in abortion. The next section describes how efforts to enforce early initiation included mass excisions under police supervision, which disrupted the timing and sequence of initiation and courtship and undermined a practice that gendered personhood and sustained generational authority. While perhaps preventing some abortions, this process enabled males to subvert women's traditional authority.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 133548.Article de périodique
Anonymous
Implementation of the New South African Abortion Law: A six month overview from hospital reports
1998 - Reproductive Health Matters, 6(145-149
Pays / Régions : Afrique du SudRésumé : no abstract
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Ahmed M.; Rahman M.; Ginneken J.
Induced abortion in Matlab, Bangladesh: Trends and determinants
1998 - International Family Planning Perspectives, 24(3), p. 128-132
Mots clés : méthodologie; enquête; grossesse non prévue; grossesse non désirée; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement; santé de la reproduction; fécondité; population; facteur démographique
Pays / Régions : Bangladesh; Asie du Sud; AsieRésumé : This study examined the reasons for induced abortion among women in Matlab, Bangladesh, and the multiple determinants of abortion. Data were obtained from the longitudinal surveillance system among about 75,000 pregnancies during 1982-91 in Matlab and comparison areas. Explanatory variables were age, parity, pregnancy interval, contraceptive use prior to pregnancy, maternal education, household space, study area, and calendar year of pregnancy termination. Of the 33,473 pregnancies during 1982-91 in the treatment area, 30,110 were live births, 1689 were miscarriages, 1064 were stillbirths, and 610 were induced abortions. The abortion ratio was 20/1000 live births in the treatment area and 33/1000 in the comparison area. Abortion ratios increased over time in both areas. The induced abortion ratio increased with maternal age and parity. The risk of induced abortion was much higher if the former pregnancy interval was under 12 months. Likelihood of induced abortion increased with maternal education and household space in both areas. The induced abortion ratio in the treatment area among contraceptive users in the former pregnancy were twice that of nonusers. Proportional hazards models indicate that abortion was more common among women with higher parity, shorter pregnancy intervals, more education, and higher socioeconomic status. During 1992-95, induced abortion and miscarriage declined in the treatment area. Higher ratios among users of some contraceptive methods suggests a link with use-failure rates. The lower level of abortion in the treatment area suggests successful maternal-child health and family planning programs.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2412898.html.Rapport
CEFOREP
Introduction des soins obstetricaux d'urgence et de la planification familiale pour les patientes presentant des complications liées à un avortement incomplet
1998 - CEFOREP, JHPIEGO, Sénégal,Résumé : En 1997, le Centre de Formation et de Recherche en Santé de la Reproduction (CEFOREP) en partenariat avec la Clinique Gynécologique et Obstétricale (CGO) du CHU Le Dantec ont entrepris une étude de faisabilité sur l'introduction des Soins Après Avortement dans trois structures sanitaires de référence de la région de Dakar : la clinique Gynécologique et Obstétricale du CHU Le Dantec, le Centre de Santé Roi Baudouin, l'Hôpital Principa.Cette expérience pilote a été appuyée par le Population Council dans le cadre du projet de Recherche Opérationnelle et d'Assistance Technique (RO/AT II) en Afrique et par JHPIEGO qui a appuyé le volet Formation / Prestations de service. Elle s'inscrit dans le cadre de la mise en oeuvre des recommandations issues des conférences internationales (Bellagio, 1993 ; Caire, 1994; Beijing, 1995) qui consacrent un rang de priorité aux Soins Après Avortement (SM) dans les stratégies de lutte contre la mortalité maternelle. Les objectifs de ce projet étaient: - objectif à long terme: de contribuer à la baisse de la morbidité et de la mortalité maternelles liées aux avortements à risque. - . objectifs immédiats : de renforcer les compétences des prestataires de services dans le domaine de la prise en charge des patientes souffrant de complications d'avortement ; de tester une stratégie de prestations de services basée sur l'introduction d'un paquet intégré de services incluant des services médicaux d'urgence, les conseils, l'orientation et les prestations de services de PF de même que la référence des patientes vers d'autres services de santé de la reproduction ; d'évaluer l'impact du modèle sur l'amélioration de la qualité des soins après avortement. La méthodologie utilisée repose sur le procédé de recherche opérationnelle avec une phase pré-test et une phase post-test entre lesquelles on introduit une intervention; les échantillons des deux phases étant indépendants. L'étude a ciblé: - les patientes souffrant de complications d'avortement dont l'âge gestationnel est inférieur ou égal à quinze semaines - le personnel de santé des structures intervenant dans la prise en charge de ces patientes. Ces cibles ont été interrogées durant les phases pré-test et post-test qui ont duré chacune 4 mois. (extrait)
Source : Source : Ceped.Chapitre d'ouvrage
Mfitzsche R.M.
La question de l'avortement
1998 - In R.M. Mfitzsche (Ed.) Enjeux éthiques de la régulation des naissances en Afrique, sexualité, fécondité, développement, p. 88-118. Louvain la Neuve: ActuelRapport
Desgrées du Loû A.; Msellati P.; Viho I.; Welffens Ekra C.
Le recours croissant à l'avortement provoqué à Abidjan depuis 10 ans des mécanismes de la récente baisse de fécondité ?
1998 - ETS/IRD ex-Orstom, Paris,
Pays / Régions : Cote d'IvoireRésumé : En Côte d'Ivoire, la fécondité a baissé rapidement au cours des 15 dernières années, puisque le nombre moyen d'enfants par femme est passé de 7,2 en 1980 à 5,7 en 1994. Plusieurs mécanismes ont rendu possible cette baisse : recul de l'âge d'entrée en union et de l'âge à la première naissance, espacement des naissances... Cependant les taux de prévalence contraceptives sont encore faibles dans ce pays, avec moins de 20% des femmes qui déclarent utiliser une méthode de contraception, et des questions demeurent quant aux méthodes par lesquelles les femmes planifient leur grossesses en Côte d'Ivoire. Une méthode possible de contrôle de la fécondité est encore très mal connue dans ce pays, car illégale et faite de façon clandestine : le recours à l'avortement provoqué. Cette étude présente les niveaux de recours à l'avortement et leur évolution observés à partir des vies génésiques de 1 201 femmes enceintes dans la ville d'Abidjan. Au vu de ces données, il semble qu'il y ait actuellement en Côte d'Ivoire un recours à l'avortement provoqué très fréquent (un tiers des femmes ont avorté au moins une fois), inconnu ou ignoré par les services de santé, et que ce phénomène soit très récent. D'après notre échantillon de femmes, la généralisation du recours à l'avortement se serait faite au cours des dix dernières années; elle a touché toute les classes d'âge, mais plus particulièrement les plus jeunes qui ont commencé à utiliser l'avortement dès le début de leur vie féconde, au contraire de leurs aînées qui l'utilisaient plutôt comme un moyen d'espacement des naissances après les premières grossesses. Cette augmentation rapide du recours à l'avortement s'est faite de façon concomitante à la baisse de la fécondité en Côte d'Ivoire et pourrait en être l'un des éléments explicatifs. (Résumé d'auteur)
Source : Source : Ceped http://www.ceped.fr/.Chapitre d'ouvrage
Leke R.J.
Les adolescents et l'avortement
1998 - In B. Kuate-Defo (Ed.) Sexualité et santé reproductive durant l'adolescence en Afrique, p. 297-306. Montréal: Ediconseil Inc.
Pays / Régions : CamerounRésumé : no abstract
Source : source : ceped.Article de périodique
Solo J.; Billings D.L.
Linkages with treatment for incomplete abortions improve family planning services in Kenya
1998 - Operations Research Alternatives, 3
Mots clés : complication; soin post-abortum; programme planning familial; counseling; femme; traitement; soin; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; clinique; hôpital; service de santé; programme
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Emergency treatment for complications of unsafe abortion and postabortion family planning counseling and services have been challenging tasks for health facilities. The Population Council and Ipas have focused on testing models for successfully integrating emergency treatment and family planning services. To test and compare the feasibility, cost, acceptability, quality and effectiveness of alternative approaches to integrating emergency treatment of abortion complications with family planning, an operations research project, entitled "Testing Alternative Approaches to Providing Integrated Treatment of Abortion Complications and Family Planning in Kenya," was conducted in six Ministry of Health hospitals. The project was undertaken by the Population Council, Ipas, the Kenyan Ministry of Health, and the Family Planning Association of Kenya. Results indicating the strengths of the approach and the challenges of implementing the models of integrated services are discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 155234.Chapitre d'ouvrage
Blayo C.
Mourir d'avortement. Facteurs politiques et sociaux
1998 - In AIDLEF (Ed.) Morbidité, mortalité : problèmes de mesure, facteurs d'évolution, essai de prospective (Colloque international de Sinaia, 1996), p. 318-326. Paris: PUF
Source : source : ined.Article de périodique
Huntington D.; Nawar L.; Hassan E.O.
One in five OB/GYN admissions in Egypt is for treatment of incomplete abortion
1998 - Operations Research Alternatives, 11-13
Mots clés : soin post-abortum; complication; traitement; soin; hôpital; hospitalisation; programme planning familial; planning familial; avortement; contraception d'urgence; contraception postcoitale; service de santé; soin; santé
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : In 1996, a postabortion case load study was conducted to investigate the number of postabortion patients in 86 public-sector hospitals in Egypt. Among the 22,656 obstetrics/gynecological admissions to the hospitals, about 19% was admitted for treatment of an incomplete abortion. Using the WHO's recommended protocol for classifying morbidity related to abortion, only 5% of the postabortion patients in Egypt can be classified as "certainly induced" and 35% as "certainly spontaneous." The majority of cases lie between these 2 poles of certainty, with 58% "possibly induced" and 2% "probably induced". However, postabortion patients appear to be underserved by Egypt's successful family planning (FP) program. It is noted that only 48% of the patients benefit from FP services despite their wide availability in Egypt's hospitals. The study results have shown the importance of postabortion care as part of the Egyptian health care system.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 160230.Article de périodique
Renne E.P.
Postinor use among young women in Southwestern Nigeria: A research note
1998 - Reproductive Health Matters, 6(11), p. 107-114Résumé : Postinor is the brand name of a progestogen-only contraceptive tablet, manufactured by a Hungarian firm1 and available in about 25 countries around the world, primarily in parts of Eastern Europe and several developing countries, including Vietnam2 Thailand3 and Nigeria.4 Although Postinor is marketed in Nigeria as a postcoital method for women having infrequent intercourse, it has not been shown to be safe or effective for this indication.5,6 This paper reports on the experience of 26 young women with post-secondary education in south western Nigeria who have used Postinor, how they heard about it, what they know about it and where they buy it. While these young women are primarily using Postinor as a postcoital method, some also are using it to test for pregnancy, to bring on menstruation and in attempts to abort or all of these as needed. It has been proposed that Postinorshould bemarketed asanemergency contraceptive, the only indication for which it has been shown to be effective, but its uses in Nigeria may not change unless the reasons why women use it are addressed
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Van de Walle E.
Pour une histoire démographique de l'avortement
1998 - Population, 53((1-2)), p. 273-290Résumé : Les sources sur l'avortement en Occident avant le XIXe siècle ne relève pas de la statistique. Littéraires, médicale, religieuses ou légales, elles révèlent peu sur son poids démographique. On peut toutefois faire une étude de fréquence des contextes dans lequel l'avortement est mentionné : par exemple, par état matrimonial de la mère, type de motivation, approbation ou désapprobation de l'auteur de la citation, efficacité probables des techniques utilisées. On peut aussi comparer la fréquence des références à l'avortement à celles portant sur des procédures rivales comme l'infanticide. Au terme de cet examen des sources très rudimentaires dont on dispose, il n'y a pas de raison déterminante de penser que l'avortement était jadis autre chose qu'une procédure incertaine, dangereuse et rare, sans poids démographique. Les procédures douces étaient probablement inefficaces ; les mesures désespérées étaient réservées aux filles abandonnées et aux prostituées.
Source : source Population : http://www.ined.fr/publications/population/index.html.Article de périodique
Rogo K.O.; Orero S.; Oguttu M.
Preventing unsafe abortion in western Kenya: an innovative approach through private physicians
1998 - Reproductive Health Matters, 6(11), p. 77-83
Mots clés : programme; loi; complication; médecin; personnel de santé; service de santé; soin post-abortum; santé de la reproduction; avortement; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; personnel de santé; soin; santé; facteur économique; programme planning familial
Pays / Régions : Kenya; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The potential contribution of physicians in the private sector to women's reproductive health in countries where abortion is illegal has been neglected. The involvement of private-sector physicians represents a means of expanding postabortion care services and thus significantly reducing the serious sequelae of unsafe abortion. A nongovernmental project launched in Western Kenya established a network of 35 private physicians and trained them to provide comprehensive, affordable postabortion care and family planning. Contraceptives are provided free by the government and clients are charged a minimal consultation fee. A preliminary project evaluation conducted by Family Planning International Assistance after 12 months of program operation indicated physicians were providing high-quality postabortion care services within their own facilities, keeping accurate records, and willing to use a sliding-scale fee schedule to ensure no woman was denied services. A total of 675 women with incomplete abortion had been treated and over 800 new family planning clients had been enrolled. The typical client treated under this program averaged 25 years of age and was 7-12 weeks pregnant. On the basis of these positive results, the project will be expanded in its second year. Planned are recruitment of non-physician providers in some rural areas, greater links between program physicians and local primary health care providers, outreach to women's groups, and community education on unwanted pregnancy.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Zaida M.; Schapink D.; J. T.B.
Protecting school gl'rls against sexual exploitation: A guardian programme in Mwanza, Tanzania
1998 - Reproductive Health Matters, 6(12), p. 19-30
Mots clés : sexualité; adolescence; adolescent
Pays / Régions : TanzanieRésumé : This paper presents a study in 1996 of a guardian programme in primary schools in two districts in Mwanza region, Tanzania, whose aim was to protect adolescent girls against sexual exploitation, which is thought to be common within educational institutions in Africa. The guardians were women teachers whose role was to help in cases of sexual violence or harassment and act as counsellors on sexual health problems. About half of the girls in the highest three classes of these primary schools (mean age 15) had had sex. Sexual exploitation of school girls by schoolboys, young men in their teens and 20s and teachers was common. The guardian programme has been well accepted and has already generated considerable public debate. One of the most important initial effects is that sexual abuse is less hidden, and abuse by teachers may have become more difficult than in the past. However, most guardians and other teachers were opposed to any sexual activity among girls, which limited their potential to encourage contraceptive use and prevention of STDs and HIV. In this context, the guardian programme should be only one component of a much broader effort to address the issue of adolescent sexuality.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Smit J.A.; McFadyen M.L.
Quinine as unofficial contraceptive -- concerns about safety and efficacy editorial
1998 - South African Medical Journal, 88(7), p. 865-866
Mots clés : contraception d'urgence; contraception postcoitale; méthode; médicament; méthode; risque; planning familial; contraception; méthode contraceptive; médicament; avortement; traitement; soin; santé publique; santé
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In South Africa, where quinine sulfate (300 mg tablets) is widely available over the counter for malaria treatment, this agent is also used as a contraceptive and abortifacient. Unpublished surveys conducted in 1993 and 1995 in KwaZulu-Natal among 61 private pharmacists and 76 quinine-purchasing clients investigated this phenomenon. 50% of pharmacists reported they sold quinine to an average of 2-6 clients per day. Quinine purchasers tended to be Black women 20-29 years of age who claimed they used the tablets for "birth prevention." Most women ingested 1-2 tablets after sexual intercourse--a dosage too low to have abortifacient action. Users reported side effects such as skin rash, tinnitus, blurred vision, nausea, and vomiting. In focus group discussions conducted in Durban, all participants were aware of quinine use for pregnancy prevention and 23% of women had taken it themselves for this purpose. Unexpected was the finding that men often take quinine to "weaken the sperm" and thus prevent conception. Other researchers have found that use of large doses of quinine as an abortifacient result in substantial maternal mortality and congenital abnormalities and few pregnancy terminations. The toxicity and teratogenicity of this agent merit serious attention. It has been speculated that quinine's toxicity is reduced in malaria because of tissue binding in plasmodial infection.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 136210.Article de périodique
Bankole A.; Singh S.; Haas T.
Reasons Why Women Have induced Abortion: Evidence from 27 countries
1998 - International Family Planning Perspectives, 24(3), p. 117-127152
Mots clés : méthodologie; enquête démographique et de santé; EDS; enquête; grossesse non prévue; grossesse non désirée; avortement; facteur socio-économique; psychologie; facteur psychologique; âge; mariage; population; facteur démographique; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial; comportement; facteur économique; état matrimonial; nuptialité; état matrimonial; mariageRésumé : This study examined abortion motivation among women. Analysis was based on published findings from 27 countries, an analysis of 3 countries, and representative surveys from 52 countries. Popline, Medline, and Population Index databases, bibliographies, and unpublished sources were also used. Women's desire to postpone or stop childbearing ranged from 39% in the Central African Republic to 89% in Japan. In 23 countries, women chose abortion for many reasons. In 4 developing Asian countries and 3 developed countries, women commonly desired a postponement or stop to childbearing. In 10 out of 20 countries, 50% of women gave birth timing and family size control reasons for abortion. A second key reason was poverty and economic concerns. Being young and unmarried was a key reason in some countries. Risk to maternal health was less important in Latin America and developed countries. African women tended to report socioeconomic reasons, followed by postponement or limiting of births. Asian women favored family size control reasons. Latin American women chose socioeconomic and relationship reasons. Developed countries favored family size control and timing reasons. In 10 countries, education was not associated, age was moderately associated, and marital status was associated with reasons. Married women tended to give socioeconomic and family size control reasons. Unmarried women cited socioeconomic factors and youth or parental objections. In the US, abortion reasons were similar to reasons for stopping childbearing. Research affirms that improved contraceptive practice is an important way to reduce abortion.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2411798.html.Rapport
Belouali R.; Guédira N.
Reproductive health in policy and practice : Morocco.
1998 - Population Reference Bureau, Washington (US), 32
Mots clés : santé de la reproduction; programme; service de santé; femme; conférence population; politique; programme; enquête; santé; soin; facteur socio-économique; facteur économique; étudiant; scolarisation; méthodologie
Pays / Régions : Maroc; Afrique Francophone; Afrique; Afrique du Nord; Pays arabes; Pays MéditerranéensRésumé : "This study is one of a number of case studies coordinated by the Population Reference Bureau (PRB), covering four countries (Morocco, Uganda, Brazil, and India). The objective of the case studies is to determine how central elements of the ICPD [International Conference on Population and Development] Programme of Action have been implemented and to identify achievements and obstacles." The present study on Morocco contains sections on demographic trends, the policy environment for reproductive health, the status of women, reproductive health programs and services, individuals' perceptions of services, and sources of financing for reproductive health care, 1991-1998. (EXCERPT)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 161647.Rapport
Camara C.M.; Cisse L.
Review of the literature on unsafe abortions in SenegalRevue de la litterature sur les avortements a risque au Senegal
1998 - CEFOREP, JHPIEGO, Dakar, 56
Mots clés : revue littérature; déterminant; avortement spontané; fausse couche; prévalence; loi; morbidité; décès; avortement; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; mesure; méthodologie; mortalité; population; facteur démographique
Pays / Régions : Sénégal; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Abortion is a significant public health and social problem in Senegal. Complications of abortion are a factor in the high maternal mortality rate of 510/100,000 live births estimated in the 1992/93 Demographic and Health Survey. A review of the limited existing literature was undertaken to assess available information on the extent, determinants, and consequences of abortion in Senegal and to identify topics requiring additional research. The work places abortion in the broader context of the reproductive health of women. The persistence of relatively high levels of postabortal morbidity and mortality contribute to the precarious reproductive health of Senegalese adolescents and women. Limited access to family planning services exposes them to risks resulting from pregnancies that occur too early, too late, or are too numerous, and to undesired pregnancies followed by abortion. Hospital surveys in Senegal suggest that abortion is widespread. The average woman hospitalized for complications of spontaneous abortion was 28 years old, married, illiterate, and the mother of at least 2 living children. Women admitted for complications of illegal abortion were 21 years old on average, often unmarried, childless, and with primary or secondary education. The principal publications on induced abortions attribute them to fear of criticism in case of an extramarital or otherwise undesired pregnancy. Abortions may damage health or lead to psychological problems, infertility, or family discord; they entail significant financial costs for the individual and society. The Senegalese penal code condemns abortion except to save the mother's life, a position apparently close to that of Islam as interpreted in Senegal. The literature review confirmed the partial state of knowledge of abortion in Senegal. Most studies were limited to the hospital setting, and qualitative studies were scarce. Little is known of abortion in rural areas.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 136364.Article de périodique
Akakpo B.
Safer young motherhood in Ghana
1998 - Planned Parenthood Challenges, 1), p. 19-21
Mots clés : programme; adolescence; adolescent; santé; grossesse adolescente; grossesse; avortement; sexualité; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial; éducation
Pays / Régions : Afrique de l'Ouest; Ghana; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : At 143/1000 women aged 15-19, sub-Saharan Africa has the highest rates of births to adolescents in the world, and the maternal mortality rate is equally high in this age group. In response to this situation, the Planned Parenthood Association of Ghana (PPAG) created a prototype Mothers Project that seeks to improve the sexual and reproductive health status of young mothers. The project has its origins in the 1972 Family Life Education program established at the Presbyterian Training College for young students. PPAG took over this program in 1984 and, realizing that girls who had dropped out of school because of pregnancy also needed attention, created a companion community-based Teens Project. The Teens Project seeks 1) to provide adolescent mothers with maternal-child health/family planning services; sexual and reproductive health information, education, and counseling; and employable skills and 2) to lobby for other support services for the adolescent mothers. In 1996, the project received a prize for innovation from the Ghana Chapter of the Forum for African Women's Education because the project had been instrumental in 1) reducing the number of adolescent pregnancies from 30% in 1991 to 12% in 1995; 2) helping young women gain self-esteem; 3) facilitating the return of young mothers to school; and 4) advocating for provision of services tailored to meet the needs of adolescent mothers.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 133004.Ouvrage
Nouijai A.e.; Makhlouf Obermeyer C.; Darkaoui K. E.; Lfarakh A.; El Youbi A.; Zguiouar A.; Mghari M.; Dialmy A.; Harrami N.; Centre d'Etudes; de Recherches Démographiques (Maroc)
Santé de reproduction au Maroc : facteurs démographiques et socio-culturels
1998 - Rabat (MA): CERED, 338 p. p.
Mots clés : contraception; méthode contraceptiveRésumé : Cette étude sur les avortements, la consultation prénatale et les grossesses non'"désirées présente le contexte juridique et religieux de l'avortement au Maroc, avant d'apprécier son volume pour se pencher ensuite sur l'évolution et les déterminants d'une part, des consultations prénatales et, d'autre part, des grossesses non désirées.. Ainsi, face au manque de données permettant d'évaluer le taux d'avortements, des estimations indirectes permettent de situer l'intensité de la pratique des avortements provoqués au Maroc à des niveaux légèrement plus faibles par exemple, de l'Égypte, et plus élevés que ceux de la Jordanie
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Gorgen R.; Yansane M.L.; Marx M.; Millimounou D.
Sexual behavior and attitudes among unmarried urban youths in Guinea
1998 - International Family Planning Perspectives, 24(2), p. 65-71
Mots clés : sexualité; contraception; méthode contraceptive; adolescence; adolescent
Pays / Régions : GuinéeRésumé : This study examined premarital sexual behavior among urban youths in Guinea. Data were obtained from interviews among 3603 15-24 year old males and females from 3 towns (Faranah, Kissidougou, and Gueckedou) in Guinea. The stratified cluster sample included 2114 primary and secondary school youths and 1489 out-of-school youths (OSYs) (apprentices and informal sector workers). Focus groups were conducted among 25 same-sex groups comprising 192 persons. 76% were aged 15-19 years of age. 42% were female. 46% belonged to the Malinke ethnic group. 50% of females and 76% of males were sexually experienced. The mean age of first intercourse was 16.3 years for females and 15.6 years for males. Students had a significantly later mean age at first sexual intercourse than OSYs. Sexually active young men had a greater mean lifetime number of sexual partners (4.0) than women (2.1). Female students had fewer partners than female OSYs. 42% of females and 44% of males did not have coitus in the previous month. 45% of females and 51% of males had sex 1-3 times. Youths preferred periodic sexual experiences. Youths reported a pressure from peers and partners to have sex. Sexually active women tended to have older partners. Only about 25% knew first coitus could result in pregnancy. 11% could not distinguish effective from ineffective contraception. 29% reported use of condoms, 20% relied on the calendar method, and 14% relied on the pill. 53% had never used any method. Nonuse was higher among OSYs. 25% reported having been pregnant. 8% reported having made a partner pregnant.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2406598.html.Article de périodique
Araoye M.O.; Fakeye O.O.
Sexuality and contraception among Nigerian adolescents and youth
1998 - African Journal of Reproductive Health, 2(2), p. 142-150
Mots clés : méthodologie; enquête; adolescence; adolescent; jeune; adolescent; étudiant; scolarisation; sexualité premaritale; contraception; méthode contraceptive; grossesse adolescente; grossesse; avortement; maladie sexuellement transmissible; MST; IST; santé de la reproduction; âge; population; facteur démographique; éducation; école; scolarisation; sexualité; comportement; planning familial; fécondité; contraception d'urgence; contraception postcoitale; IST; MST; infection; complication; maladie; complication; santé
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : To guide the design of reproductive health programs for Nigerian youth, interviews were conducted with 971 students 18-24 years of age enrolled at a college in Ilorin, Kwara State. Overall, 62.8% of respondents were sexually active. Sexual intercourse had been experienced by 58.8% of males and 30.9% of females by the age of 19 years. Despite widespread awareness of contraception and the sexual transmission of HIV, only 72% of sexually active males and 81% of females had ever used a method. Condoms were the method most commonly used by male students (43%), while the largest number of female students selected rhythm (31%). 13.4% of males reported making a partner pregnant and 69% of these pregnancies had been aborted. 9.1% of females had been pregnant, and 75.6% of these pregnancies were terminated by abortion. 8.7% of males reported a past history of a sexually transmitted disease (STD), primarily gonorrhea. Even though 21% of all respondents (9.9% of females and 33% of males) were at high risk of contracting an STD/HIV as a result of having sexual intercourse with casual and/or commercial partners without consistent condom use, perception of personal risk was low. Recommended, to protect the reproductive health of Nigerian college students, is the provision of integrated STD management and family planning services through college health services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 137804.Article de périodique
Meskel Y.W.
STD and induced abortion
1998 - Africa Health, 20(6), p. 2
Mots clés : avortement; grossesse non prévue; grossesse non désirée; maladie sexuellement transmissible; MST; IST; déterminant culturel; abstinence post-partum; risque; sexualité; adultère; relation extraconjugale; contraception; méthode contraceptive; demande; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; IST; MST; infection; complication; maladie; complication; abstinence; contraception; comportement; éducation; facteur économique
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : In Gambella, southwestern Ethiopia, sexual intercourse following the birth of a baby is not allowed until the child is 2-3 years old. Whilst most mothers wait for the specified time, their husbands find it difficult and seek sex elsewhere. This cultural law therefore increases the risk of STD transmission. The "rule" is obviously hard for some young couples to keep. They have sexual intercourse without contraception, resulting in pregnancy. The wife, not wishing to be seen to have broken the law, seeks an abortion. Cultural modification requires a long period of time but health education about STDs and contraception is, meanwhile, indispensable. (full text)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 137517.Article de périodique
Cohen B.
The emerging fertility transition in sub-Saharan Africa
1998 - World Development, 26(8), p. 1431-1461
Mots clés : enquête démographique et de santé; EDS; fécondité; déterminant fécondité; mariage; état matrimonial; contraception; méthode contraceptive; transition fécondité; enquête; population; facteur démographique; taux natalité; taux fécondité; résidence; facteur géographique; nuptialité; état matrimonial; mariage; planning familial
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : This report summarizes and clarifies recent evidence on levels, trends, and differences in fertility, marriage, and contraceptive use in sub-Saharan Africa. Data were obtained from a variety of sources. Appendix A provides recent total fertility rates (TFRs). Most TFRs indicate large African families. Only a few African countries have fertility under 5 children/woman, but not lower than 4. TFRs in 14 East African countries range from 4.3 in Zimbabwe to 6.9 in Uganda; in 14 West African countries they range from 5.5 in Ghana to 7.4 in Niger. Kenya's TFR may have increased over the decades. Cameroon and other Central African countries had an increased TFR in the 1970s and 1980s. The Central African Republic had very high rates of infertility. Signs of fertility decline are appearing. Cleland's parity/current fertility ratio shows distinct patterns of fertility decline in Zimbabwe, Kenya, Botswana, N. Sudan, Cote d'Ivoire, Ghana, Kenya, Lesotho, Namibia, Tanzania, and Zambia. Declines are strongest in east and southern Africa. Fertility is declining in all 5 southern African countries and among all educational levels in TFR declining countries. Fertility is lower in urban areas. Kenya, Botswana, Zimbabwe, and Cote-d'Ivoire show declines due to child spacing use of contraception. Kenya and Botswana have fewer adolescent births but more unmarried teenage births. Later age at marriage and first birth is occurring in Kenya, Uganda, Zimbabwe, Mauritania, Nigeria, Senegal, Togo, and Ghana. Contraceptive prevalence rates (CPRs) vary by region. CPRs are highest in declining fertility countries. Unmet need for family planning ranges from 28% to 65%.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 137916.Article de périodique
Zabin L.S.; Kiragu K.
The health consequences of adolescent sexual and fertility behavior in Sub-Saharan Africa
1998 - Studies in Family Planning, 29(2), p. 210-232
Mots clés : revue littérature; adolescence; adolescent; santé de la reproduction; sexualité premaritale; grossesse adolescente; grossesse; culture; mariage; état matrimonial; âge; jeune; adolescent; population; facteur démographique; santé; sexualité; comportement; fécondité; nuptialité; état matrimonial; mariage
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : A review of the literature on the health consequences of adolescent sexual behavior and childbearing in sub-Saharan Africa reveals substantial contextual variation. Among the more general factors impacting on early sexual onset and childbirth are younger age at menarche, erosion of social and cultural controls on premarital sex, the abandonment of pubertal rites of passage, and more widespread schooling. Childbearing at young ages has been associated with pregnancy-induced high blood pressure, anemia and hemorrhage, obstructed and prolonged labor, infection, and higher rates of infant morbidity and mortality. Both cultural and biologic factors elevate the likelihood of transmission of sexually transmitted diseases, including HIV, among female adolescents. Many sequelae common to all adolescents are exacerbated by cultural practices such as genital mutilation. It is often assumed that the health problems of adolescent females will be addressed by general improvements in women's health services. However, the level of care required by adolescents who are delivering a first child is considerably greater than that required by healthy adult women. Moreover, may women's health services are hostile to teens who initiate coitus out of wedlock and may even deny treatment. Ultimately, prevention may depend more on changes in public policy and consideration of cultural context than upon specific programs.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 134491.Article de périodique
Henshaw S.K.; Singh S.; Oye Adeniran B.A.; Adewole I.F.; Iwere N.; Cuca Y.P.
The incidence of induced abortion in Nigeria
1998 - International Family Planning Perspectives, 24(4), p. 156-164
Mots clés : méthodologie; enquête; taux; avortement; incidence; médecin; personnel de santé; contraception d'urgence; contraception postcoitale; planning familial; mesure; personnel de santé; soin; santé
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Although abortion is illegal in Nigeria except to save a woman's life, Nigerian women obtain thousands of safe and unsafe pregnancy terminations each year. To generate information on the likely incidence of abortion in Nigeria, a national random sample survey was conducted in 1996-97 of all public and private health establishments where abortions might be performed or abortion complications might be treated. The final sample included physicians from 672 private and public medical facilities and teaching hospitals. Respondents were asked whether their facility terminated unwanted pregnancies and, if so, how many had been terminated during the past 6 months and how many in the last 4 weeks. 225 facilities performed abortions (average number of abortions per facility per year, 52) and 529 provided treatment of abortion-related complications (average number of cases per year, 48). 40% of abortions were performed by physicians in established health facilities, while the remainder were performed by nonphysicians. Of the abortions performed by physicians, 87% take place in privately owned facilities and 73% are performed by nonspecialist general practitioners. 75% of physician providers of abortion and 51% of providers who treat abortion complications use manual vacuum aspiration. National projections indicate that physicians in approximately 1300 hospitals and clinics terminate 245,000 pregnancies each year and nonphysicians provide an additional 366,000 abortions. Assuming that half of all women who undergo abortion by nonphysicians experience complications requiring treatment, there are about 610,000 abortions nationwide per year (rate, 25 abortions/1000 women 15-44 years old). The minimum and best estimates for the number of abortions per 100 live births are 10/100 and 14/100, respectively. The rate is much lower in the poor, rural regions of northern Nigeria than in the more economically developed southern regions.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2415698.html.Article de périodique
Singh S.; Ratnam S.
The influence of abortion legislation on maternal mortality
1998 - International Journal of Gynecology Obstetrics, 63(suppl. 1), p. S123-S129
Mots clés : législation; loi; complication; mortalité maternelle; incidence; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; mortalité; population; facteur démographique; mesure; méthodologie
Pays / Régions : Singapour; Asie du Sud Est; AsieRésumé : This paper on the influence of abortion legislation on maternal mortality opens by noting that 585,000 women die from pregnancy- and childbirth-related causes each year and that all but about 250 of the 150,000 annual abortion-related deaths are preventable. The next section reviews the incidence of induced abortion (36-51 million each year, with 26-31 million being legal) and provides a table and a figure that reveal that the global incidence of unsafe abortion is approximately 20 million/year, resulting in approximately 70,000 deaths with many more women suffering serious complications that require treatment from seriously strained health care systems. Section 3 categorizes abortion laws as very strict (50 countries), rather strict (44 countries), rather broad (13 countries), and on request (22 countries). The most populous countries tend to have liberal laws, so only 25% of women worldwide have no access to legal abortion and 40% of women can decide for themselves. The next section discusses the fact that liberalizing abortion legislation leads to a tremendous decrease in maternal mortality rates because legalization allows abortion to be performed by trained providers using proper facilities and equipment and because accessibility and information dissemination allows women to seek abortions earlier in pregnancies. Section 5 notes the contrary effect of restrictive abortion legislation on maternal mortality, and section 6 reviews Singapore's experience in liberalizing abortion legislation. The article concludes that safe abortion services will always be needed and should be available worldwide.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 140554.Article de périodique
Huntington D.; Nawar L.; Hassan E.O.; Youssef H.; Abdel Tawab N.
The postabortion caseload in egyptian hospitals: A descriptive study
1998 - International Family Planning Perspectives, 24(1), p. 25-31
Mots clés : méthodologie; enquête; soin post-abortum; hôpital; hospitalisation; taux; prévalence contraceptive; curetage; méthode; dilatation curetage; méthode; Anesthésie; antibiotiques; méthode; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; service de santé; soin; santé; contraception; méthode contraceptive; intervention chirurgicale; méthode; intervention chirurgicale; traitement; soin; médicament; méthode
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : In 1996, the Egyptian Fertility Care Society and the Population Council's Africa and Near East Operations Research/Technical Assistance Project conducted a study of 86 Ministry of Health and University Medical hospitals (15% of public sector hospitals) to determine the volume and nature of the postabortion caseload in public sector hospitals in Egypt. Egypt has a rather restrictive abortion policy. A medical record abstract form for all postabortion cases and a daily tally sheet for all obstetric/gynecologic (Ob/Gyn) admissions during a 30-day period were the data collection methods used. 19% of all Ob/Gyn admissions underwent treatment for abortion (miscarriage and induced abortions combined). These women were 20 to 50 years old. Spontaneous abortion accounted for 35% of the abortion cases. Induced abortion appeared to comprise the remaining cases (58% possibly induced, 5% certainly induced, 2% probably induced). About 61% of abortion patients had no formal education. The researchers estimated the abortion ratio for Egypt to be 14.75 abortions/100 pregnancies. About 56% of the postabortion patients lived more than 5 km away from the hospital. They were 26% more likely to suffer from severe hemorrhaging than those living closer to the hospital. 69% referred themselves to the hospital, a strong indication of a weak referral system for abortion complications from the primary health care system. Around 47% had ever used a contraceptive method. 17% were using a contraceptive method at the time of conception. About 42% aimed to use a contraceptive method during the postabortion period. The mean duration of hospital stay was 16.7 hours (range, 1-248 hours). Mean gestational age at time of abortion was 10.8 weeks (range, 2-28 weeks). 86% had a gestational age of 12 weeks or less. 95% of postabortion patients underwent dilatation and curettage. 56% received no pain control medication; 10% received no antibiotics; 52% received therapeutic antibiotics. About 3% of cases with signs of infection received no antibiotics. The case fatality rate was 0.43%. The findings will be used to improve postabortion care in Egypt.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2402598.html.Rapport
World Health Organisation
Unsafe abortion. Global and regional estimates of incidence and mortality due to unsafe abortion with a listing of available country data
1998 - World Health Organisation, Geneva, 109Résumé : Millions of women every year have an unwanted pregnancy, which ends through an unsafe abortion. This document presents global and regional estimates of incidence of and mortality due to unsafe abortion. The tabulations consist of data collected from a variety of sources, including health service reporting and surveys. Global and regional estimates are derived from data in the country listings. A description of materials and methods is included. Unsafe abortion is characterized by the lack or inadequacy of skills of the provider, hazardous techniques, and unsanitary facilities. It is one of the great neglected problems of health care in developing countries and a serious concern to women during their reproductive lives. Prevention of unwanted pregnancies must be the highest priority, and every attempt must be made to eliminate the need for abortion. Where contraception is unavailable or inaccessible, many women will seek to terminate unwanted pregnancies despite restrictive laws and lack of inadequate services. Women who resort to unauthorized providers put their health and lives at risk. It is estimated that every year almost 20 million unsafe abortions take place in developing countries, where the risk of death is estimated at 1 out of every 260 procedures
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 137486.Article de périodique
Koster Oyekan W.
Why resort to illegal abortion in Zambia? Findings of a community-based study in western province
1998 - Social Science Medicine, 46(10), p. 1303-1312Résumé : This article presents part of the findings of a community-based study on the causes and effects of unplanned pregnancies in four districts of Western Province, Zambia. The study broke the silence around abortion in Western Province and revealed that induced abortion poses a public health problem. Using innovative methodology of recording and analyzing histories of deaths from induced abortion, the abortion mortality ratio was calculated for the study districts. Findings reveal all extremely high induced abortion mortality ratio of 120 induced abortion-related deaths per 100,000 live births. More than half the deaths were of schoolgirls. Although abortion in Zambia is legal on medical and social grounds, most women in Western Province resort to illegal abortions because legal abortion services are inaccessible and unacceptable. The main reasons women resort to abortion is for fear of being expelled from school, their unwillingness to reveal a secret relationship, to protect the health of their previous baby and common knowledge that postpartum sexual taboos have been transgressed. An inventory was made of abortion methods, taboos and abortion-providers. The article describes how health staff were involved throughout the study, and shows how recommendations were made by involving all parties concerned.
Source : Source : Social Science Medicine.Article de périodique
Osakue G.; Martin Hilber A.
Women's sexuality and fertility in Nigeria: breaking the culture of silence
1998 - 180-216
Mots clés : femme; droit; santé de la reproduction; culture; facteur économique; décision; enquête; focus group; enquête; facteur politique; programme planning familial; contraception; méthode contraceptive; avortement; excision; VIH; service de santé; genre; éducation; activité économique; sexualité; âge; mariage; état matrimonial; mariage; divorce; fécondité; perception; facteur socio-économique; santé; planning familial; comportement; collecte; méthodologie; politique; programme; contraception d'urgence; contraception postcoitale; maladie; maladie; complication; soin; psychologie; facteur psychologique; population; facteur démographique; nuptialité; état matrimonial; mariage
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : An International Reproductive Rights Research Action Group [IRRRAG] team "sought to learn how Nigerian women negotiate, accommodate or occasionally reject male control over their fertility and sexuality, and how these patterns change over the course of their life cycle. In so doing, [the researchers] found that the women [they] interviewed straddle the gap between patriarchal tradition and economic necessity when it comes to reproductive and sexual decision-making." 354 ethnically diverse women participated in group discussions; some were also interviewed. The political and economic situation in Nigeria is first sketched out. Then there are sections discussing the status of women; reproductive health and health policies, including contraception, abortion, HIV, female circumcision, and public health care; the women's movement; gender socialization, education, and work; sexuality; aging; marriage, including polygamy; divorce; and childbearing and fertility regulation, including abortion. (EXCERPT)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - IND RH91392.Article de périodique
Goyaux N.; Calvez T.; Yace Soumah F.; Welffens Ekra C.; Faye E.O.; De Bernis L.; Diadhiou F.; Goufodji M.; Alihonou E.; Carre N.; Thonneau P.
[Obstetric complications of the first trimester in Western Africa]
1998 - J Gynecol Obstet Biol Reprod (Paris), 27(7), p. 702-707.
Mots clés : méthodologie; complication grossesse; hôpital; hospitalisation; traitement; soin; issue grossesse; grossesse; santé de la reproduction; maladie; complication; médecine; service de santé; soin; santé
Pays / Régions : Bénin; Sénégal; Cote d'Ivoire; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : In West Africa, most women presenting with obstetrical complications during the first trimester of pregnancy are referred for consultation with the gynecology-obstetrical services of reference hospitals. Obstetrical complications affecting women in Benin, Senegal, and Cote d Ivoire during the first trimester of pregnancy were studied. Data on the 345 women included in the study were collected during January-April 1997, from registers maintained by the 8 participating maternity units. 95 women were from Benin, 95 from Senegal, and 155 from Cote d Ivoire. Study subjects were of mean age 25.9 years, having experienced a mean 2.9 pregnancies by the time of the study. The most frequent complications observed were spontaneous abortions, complications of induced abortion, and ectopic pregnancy, observed in 50%, 34%, and 8% of admissions, respectively. Overall, the patients appear to have rapidly gained access to care, with two thirds of the women undergoing interventions on the day of admission. However, despite such service, 3 mothers died, 2 of which following induced abortion complications.French Abstract: En Afrique de l'Ouest, la plupart des femmes qui se présentent avec des complications obstétriques durant leur premier trimestre de grossesse sont envoyées aux services gynécologiques-obstétriques des hôpitaux de référence. Les complications obstétriques qui touchent les femmes au Bénin, au Sénégal, et en Côte d'Ivoire durant le premier trimestre de grossesse ont été étudiées. Les données sur les 345 femmes incluses dans l'étude ont été recueillies pendant la période de janvier en avril 1997, des registres gardés par les huit centres d'accouchement participants. 95 femmes étaient du Bénin, 95 du Sénégal, et 155 de la Côte d'Ivoire. Elles avaient 25,9 ans en moyenne, avec 2,9 grossesses en moyenne à date dans leurs vies reproductives au moment de l'enquête. On voyait le plus souvent des complications des fausses couches, des complications de l'avortement, et la grossesse ectopique, vues chez 50%, 34%, et 8% des cas, respectivement. En général, ces sujets semblent avoir obtenu un accès rapide aux soins, avec deux tiers des femmes ayant des interventions médicales à la même journée que l'admission aux services. Néanmoins, malgré la provision de tels services, trois mères sont mortes, dont deux étaient suite aux complications de l'avortement.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148469.
1996Article de périodique
Adjase E.T.
"Hu M'Ani So Ma Me Nti" (Two Heads are Better than One): teenage sexuality, unwanted pregnancy and the consequences of unsafe abortion in Sunyani district, Ghana
1997
Mots clés : méthodologie; revue littérature; adolescence; adolescent; sexualité; grossesse non prévue; grossesse non désirée; avortement; culture; psychologie; facteur psychologique; facteur socio-économique; facteur politique; service de santé; sexualité premaritale; jeune; adolescent; âge; population; facteur démographique; comportement; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial; facteur économique; soin; santé
Pays / Régions : Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This master's thesis examines patterns of adolescent premarital sexual behavior in Ghana, with particular reference to the scope and magnitude of unwanted pregnancy and unsafe abortion. The author reviews the literature on sociocultural, economic, and legal factors that influence teenage sex behavior in Ghana and sub-Saharan Africa. The study focuses on Sunyani district, which is 1 of 13 administrative districts in the Brong-Ahafo region of Ghana. It is concluded that the influences of Western culture are reflected in a growing gap between the age of menarche and the age of marriage, the breakdown of traditional family values and networks, the decline in traditional systems for teaching about sexual health, the absence of privacy in family planning service provision, a fast changing social system, and limited financial support to adolescents. Policy makers and influentials in the health, education, youth and social welfare, religious, criminal justice, and community sectors must be informed about the size of the problem and the consequences for girls. Those in the medical community who understand the problem need to be involved in all phases of decision making in planning, implementation, monitoring, and evaluation. Institutions should aim to reduce the number of unwanted pregnancies and unsafe abortions and to introduce comprehensive postabortion care, counseling, and family planning. People who are opposed to adolescent sex education need to be influenced with tact and diplomacy and scientific data. The author recommends 13 interventions and describes empirical and narrative research on teenage abortion and sexuality. Pregnant teenagers who are denied a legal abortion in Sunyani district will seek an illegal and unsafe abortion, accept early motherhood with or without marriage, or face the hardships of unwanted childbearing, which negatively impacts on their health and emotional well-being.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 127674.Article de périodique
Hardon A.
A review of national family planning policies
1997 - 15-21
Mots clés : santé de la reproduction; droit; programme planning familial; politique; programme; avortement; programme; santé; service de santé; planning familial; population; facteur démographique; contraception d'urgence; contraception postcoitale
Pays / Régions : Bangladesh; Kenya; Mexique; Nigeria; Thaïlande; Bolovie; Finlande; Pays Bas; Asie du Sud; Asie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Amérique du Nord; Amérique; Amérique Latine; Afrique de l'Ouest; Asie du Sud Est; Amérique du Sud; Europe du Nord; Europe; Europe de l'OuestRésumé : This document is the second chapter in a book that examines the quality of reproductive health care from a feminist perspective by considering the extent to which reproductive rights are realized in eight countries that have ratified the UN Convention on the Elimination of All Forms of Discrimination Against Women (Bangladesh, Kenya, Mexico, Nigeria, Thailand, Bolivia, Finland, and the Netherlands). This chapter evaluates how well the population policies of the eight countries respect reproductive rights. Research involved examination of the policies and programs of governmental and nongovernmental agencies providing family planning (FP) services to uncover objectives, targets, and restrictions. Some population policies are still tied to demographic goals (Bangladesh and Kenya), others have demographic and health goals (Mexico, Nigeria, and Thailand), and some countries lack a formal population policy (Bolivia, Finland, and the Netherlands). Restrictions embedded in national FP policies in several of the countries include requirements for spousal consent for sterilization. Access is also denied through a lack of programs targeting adolescents and the existence of gender biases. Access to abortion is restricted in the six developing countries, and only Kenya and Mexico mention male responsibility in FP (but the specific male role remains unclear). Kenya and Mexico also provide exceptions to the general failure to mention quality of FP care in policy documents (Kenya has formulated clinic service goals to enhance quality of care), but Thailand incorporates specific training requirements for FP personnel (an aspect of quality of care) in its population policy. Quality of care concerns are addressed by professional associations and service provider organizations. The target orientation of most of the population policies reviewed, however, could be expected to reduce quality of care. Despite these targets, services are often limited to married women.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 127729.Congrès
Huntington D.
Abortion in Egypt
1997 - Seminar "Cultural Perspectives on reproductive Health", June 16-19, 1997, Rustenburg, South Africa, IUSSP, 19p p.
Pays / Régions : Egypte
Source : source : Ceped.Article de périodique
Anonymous
Abortion law reform in Namibia
1997 - Reproductive Health Matters, 5(10), p. Page 170
Pays / Régions : Namibie
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Radhakrishna A.; Greesiade R.
Adolescent women face triple jeopardy: unwanted pregnancy, HIV AIDS and unsafe abortion
1997 - Women's health women, 2(53-62
Mots clés : VIH; sida; avortement; risque; adolescence; adolescent; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; maladie; maladie; complication; contraception d'urgence; contraception postcoitale; planning familialRésumé : This article reports the risks of unwanted pregnancy and unsafe abortion relative to HIV/AIDS by adolescent women. Data presented at the XI International Conference on AIDS indicated that adolescents aged 15-19 years form the highest risk group for newly acquired HIV infections and also with the highest rate worldwide of unwanted pregnancy. Contributing factors of this high rate includes physical violence and other forms of coercion; an earlier age of sexual initiation for girls than boys; so-called "sexual mixing", wherein young girls may have sex with older men for a variety of cultural and economic reasons; social pressures faced by young girls; the lack of access to formal education including sex education; the lack of access to contraception and reproductive health services; the high-risk sexual behavior of adolescent female partners; and young women's lack of power to negotiate terms of sex with their partners. When faced with an unwanted pregnancy, adolescent women have always found it difficult to obtain appropriate services to meet their needs, including safe abortion care. The AIDS epidemic exacerbates these difficulties and adds new medical, legal and ethical dimensions to the practice of unsafe and illegal abortion procedures that put young women's health and lives in danger.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 144676.Article de périodique
Anonymous
An act (No. 92 of 1996) to determine the circumstances in which and conditions under which the pregnancy of a woman may be terminated; and to provide for matters connected therewith. Date of assent: 12 November 1996. (The Choice on Termination of Pregnancy Act, 1996
1997 - International Digest of Health Legislation, 48(2), p. 178-181
Mots clés : loi; counseling; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé; clinique; hôpital; service de santé; programme; information
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This document contains major portions of the text of South Africa's 1996 Choice on Termination of Pregnancy Act that repealed all prior abortion-related legislation. The Act recognizes the right of persons to make decisions about reproduction; to have control over their bodies; to have access to safe, effective, affordable, and acceptable methods of fertility regulation; and to reproductive health care. The Act further asserts that abortion is neither a form of contraception nor a means of population control. Under this Act, abortion is performed upon request of the pregnant woman during the first 12 weeks of pregnancy. From week 13 to 20, abortion can be performed if a medical practitioner agrees that the pregnancy would injure the woman' physical or mental health, the fetus risks a severe physical or mental abnormality, the pregnancy resulted from rape or incest, or the pregnancy would affect the social or economic circumstances of the woman. Abortions can only take place after 20 weeks gestation if the pregnancy would endanger the woman's life, involves a severely malformed fetus, or would risk injury to the fetus. All abortions after week 12 must be carried out by a medical practitioner. The Act also describes where abortions may be performed, the promotion of counseling, informed consent requirements, provision of information about abortion rights, and notification and record-keeping requirements.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 128187.Article de périodique
Kay B.J.; Katzenellenbogen J.M.; Fawcus S.; Abdool Karim S.S.
An analysis of the cost of incomplete abortion to the public health sector in South Africa -- 1994
1997 - South African Medical Journal, 87(4), p. 442-447
Mots clés : méthodologie; coût; service de santé; hôpital; hospitalisation; contraception d'urgence; contraception postcoitale; planning familial; facteur économique; soin; santé
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Findings are presented from the assessment of public sector hospital medical costs incurred treating women in South Africa for incomplete abortions regardless of origin. A panel of 15 senior level obstetrician/gynecologists working in 14 different hospital settings helped to develop symptom severity categories, while a second panel of 11 patient care managers representing district, regional, and tertiary level hospitals in seven provinces estimated resource use. A conservative estimate of R18.7 million +or- R3.5 million was spent in 1994 to treat women in public hospitals for incomplete abortion, of which an estimated R9.74 million +or- R1.3 million was spent treating women with unsafe incomplete abortions. Managing incomplete abortions therefore consumes considerable public sector resources.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 123106.Article de périodique
Jewkes R.K.; Wood K.; Maforah N.F.
Backstreet abortion in South Africa editorial
1997 - South African Medical Journal, 87(4), p. 417-418
Mots clés : demande; complication; offre contraception; avortement; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement; contraception; méthode contraceptive
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : South Africa's 1996 Termination of Pregnancy Bill represents an important opportunity to improve women's reproductive health by removing the risk of death and disability associated with illegal abortion. Historical sources indicate that abortion has been practiced in South Africa among all social classes and ethnic groups since the mid-1800s. Although statistics are impossible to compile under conditions of illegality, government sources estimate that from 6000 to 120,000 such procedures are performed each year. Qualitative survey data indicate that, although South Africa has a contraceptive prevalence rate of 53%, large numbers of women use their method incorrectly (e.g., use the pill only on days they have sex) and face strong male disapproval of fertility control. Other factors contributing to the need for abortion include a high incidence of forced sex, especially among adolescents, and hostile, judgmental attitudes on the part of family planning nurses toward unmarried women who request contraception. The primary reasons women seek termination of pregnancy are financial pressures, a need to continue their education, and pressure from relatives or male partners. Since women who consult their doctors about abortion are almost always sent away, they resort to self-inducement or seek the services of illegal abortionists. In many cases, they depend on health services to "finish the job." The maternal mortality rate associated with illegal abortion may be as high as 37/100,000 live births.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 122699.Article de périodique
Maforah F.; Wood K.; Jewkes R.
Backstreet abortion: women's experiences
1997 - Curationis, 20(2), p. 79-82
Mots clés : méthodologie; enquête; avortement; grossesse non prévue; grossesse non désirée; décision; loi; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; comportement
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In order to determine why and how women in South Africa obtain illegal abortions, a descriptive study was conducted in six public hospitals in four provinces. Data were gathered via semi-structured, in-depth interviews with 25 women hospitalized with complications of self-confessed induced abortion (64% Africa, 20% Indian, and 16% Colored). 3 of the 5 married women were separated from their husbands. Almost half of the subjects were adolescents, and the mean age was 25 years. All of the women were aware of contraceptives but failed to use them or used them improperly. In some cases, the male partners disapproved of contraception or initiated intercourse in such a way that disempowered the women, making them unable to negotiate contraceptive usage. Most of the women felt they had no choice but to seek abortion because their sexual relationships or financial circumstances were unstable. The compulsion to seek abortion overrode all legal and religious considerations. The women, who had to self-induce or seek illegal abortion, felt that the current law placed a tremendous burden on them at a time of extreme trauma. The women also complained about their treatment at the hands of the abortionists and, later, by the hospital staff. Thus, the 1975 abortion and Sterilization Act has failed to limit the number of abortions. The law should be amended to make abortion accessible, safe, and less expensive to obtain. In addition, men should be targeted recipients of family planning and contraception information.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 131497.Article de périodique
Renne E.P.
Changing patterns of child-spacing and abortion in a northern Nigerian town
1997
Mots clés : méthodologie; enquête; adolescence; adolescent; grossesse non prévue; grossesse non désirée; espacement naissance; avortement; femme; éducation; étudiant; scolarisation; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; planning familial; contraception d'urgence; contraception postcoitale; famille; facteur socio-économique; facteur économique
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This paper examines the link between the changing patterns of abortion and child spacing practices and maternal education in Zaria, Nigeria, during 1994-96. Married women and secondary female students were interviewed to clarify the extent and method of abortion practices of both groups. The study was not able to quantify the exact number of induced abortion since most of the respondents were reluctant to report abortion experiences. On the other hand, prolonged birth intervals have been reported to be associated with education, breast-feeding, antenatal clinic attendance, hospital deliveries, and use of western medicines. For the past 20 years, education among women in Zaria was noted to have affected abortion practices in two ways: 1) education provided alternative advice on child spacing, which has resulted in a decline in the need for abortion among married women; 2) increased abortion needs among secondary school women who want to complete their education were observed. The biosocial gap on fertility problems and educational attainment existing in these groups has been addressed by several community sectors. Secondary schools have encouraged married women to attend secondary school despite marital status and pregnancy. This paper concludes that further research on the extent of abortion among secondary students must be conducted to assess the immediate problem and formulate appropriate solutions.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147288.Article de périodique
Anonymous
Choice on Termination of Pregnancy Act 1996: Republic of South Africa
1997 - Reproductive Health Matters, 9), p. 116-118
Mots clés : législation; loi; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique du Sud; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This article reproduces substantive parts of South Africa's 1996 Choice on Termination of Pregnancy Bill and provides a commentary on the law. The law states that pregnancies can be terminated under the following circumstances: 1) upon request of a woman during the first 12 weeks of gestation; 2) from week 13 to 20 if the pregnancy risks injury to the woman's physical or mental health, if the fetus risks being severely abnormal, if the pregnancy resulted from rape or incest, or if the pregnancy would significantly affect the woman's socioeconomic status; and 3) after week 20 if the pregnancy endangers the woman's life, would result in severe malformation of the fetus, or poses a risk of injury to the fetus. Trained, registered midwives may perform pregnancies up to week 12. Abortions must take place at designated facilities, and the state is to promote provision of nonmandatory and nondirective preabortion counseling. Abortion requires only the informed consent of the woman involved, and minors are to be urged but not forced to consult with their family and friends before undergoing the procedure. If a woman is unable to give consent due to severe mental disability of a state of continuous unconsciousness, the procedure can take place with the consent of legal guardians or curator personae as long as two medical practitioners or a medical practitioner and a registered midwife consent. The Act requires that facilities maintain records about abortions that will be regularly forwarded to the Director-General of Health.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Hardy E.; Bugalho A.; Faundes A.; Duarte G.A.; Bique C.
Comparison of women having clandestine and hospital abortions: Maputo, Mozambique
1997 - Reproductive Health Matters, 9), p. 108-115
Mots clés : méthodologie; enquête; avortement; loi; demande; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : While abortion remains illegal in Mozambique, the Ministry of Health issued a decree in the early 1980s that authorizes hospitals to provide abortions for women who conceived while using an IUD or if the woman's health is in danger. The interpretation of this decree has been broadened by a consideration that the health of a woman is always in danger if she is so desperate for an abortion that she would resort to a clandestine procedure. Thus, the hospital in Maputo has provided an increasing number of abortions. Despite this, many women are still admitted for treatment of complications of clandestine abortions. A study was undertaken to compare the sociodemographic characteristics of 400 of these women with those of 416 women requesting abortion in the hospital. Upon comparison with the hospital groups, it was found that the clandestine group included three times as many women under 20 years old and half the number of women 30 or more years old. Women in the clandestine group had experienced fewer pregnancies and fewer abortions and had fewer living children. Only 25% of the clandestine group lived with a male partner, compared to 42% of the hospital group. More pregnancies in the clandestine group resulted from an occasional encounter, and only half (as opposed to 25% in the hospital group) used contraceptives at conception. The women in the clandestine group had significantly lower levels of education, and more had migrated to Maputo in the previous 3 years, were unemployed, lived in poorer housing conditions, and were Blacks. Over 90% of the women in both groups knew of a modern method of contraception, but the women in the clandestine group used contraception significantly less often. It is recommended that contraception information and services be improved and that hospital-based abortion services be extended to other hospitals.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Abdel Tawab N.; Huntington D.; Hassan E.O.; Youssef H.; Nawar L.
Counseling the husbands of postabortion patients in Egypt: effects on husband involvement, patient recovery and contraceptive use. Final report
1997
Mots clés : méthodologie; couple; programme; counseling; avortement; soin post-abortum; genre; psychologie; facteur psychologique; contraception; méthode contraceptive; famille; clinique; hôpital; service de santé; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; programme planning familial; relation; comportement; facteur économique
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : This study evaluated the effects of counseling husbands about their spouses' health, recovery from abortion, and post-abortion use of contraception in Egypt. In-depth interviews were conducted with 220 cases and 220 controls among patients in six hospitals in Menia, Egypt. Abortion was performed with manual vacuum aspiration methods. Messages relayed in counseling of husbands concerned: the need for rest and adequate nutrition for wives, post-abortion; post-abortion warning signs that required follow-up care; a return to fertility within two weeks; the need for family planning to avoid unwanted or poorly timed pregnancy; and the causes of miscarriage and sources of referral care. Messages were adapted to couple situations. For example, the need for family planning was emphasized for couples with closely-spaced pregnancies, or those desiring a stop to childbearing. Counseling was performed by the attending physician just before patient release from the hospital. Findings reveal that there were no meaningful differences between cases and controls in the types and amount of husband support or in the effects on patient outcome/recovery. Counseling of husbands was associated with better emotional recovery, if the woman was older than 35 years or had one or more sons. Counseling of husbands was most likely to be associated with intended or actual use of contraception among couples with 1-2 children. Physicians with 6 days of training and service as a Master Trainer were better counselors. Husbands appreciated the counseling and desired more information on contraception and the timing of a return to sexual activity.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 131273.Ouvrage
Ouedraogo C.M.; Ouadraogo A.C.
Enquête qualitative de base sur les opinions en matière de reproduction : rapport scientifique
1997 - Ouagadougou (BF): UERD, 73 p. p.
Mots clés : contraception; méthode contraceptive
Pays / Régions : Burkina Faso
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Singh S.; Cabigon J.V.; Hossain A.; Kamal H.; Perez A.E.
Estimating the level of Abortion in the Philippines and Bangladesh
1997 - International Family Planning Perspectives, 23(3), p. 100-107
Mots clés : méthodologie; taux; complication; régulation menstruelle; incidence; loi; contraception d'urgence; contraception postcoitale; planning familial; mesure
Pays / Régions : Philippines; Bangladesh; Asie du Sud Est; Asie; Asie du SudRésumé : In both the Philippines and Bangladesh, a lack of reliable data on induced abortion requires the use of various estimation techniques to assess the number of procedures performed. The Philippine penal code contains a general prohibition on abortion, yet about one-third of such procedures are performed by nurses or physicians. In Bangladesh, abortion is permitted only to save a woman's life; however, menstrual regulation is not covered by the penal code, and this procedure accounts for about twothirds of all voluntary pregnancy terminations. Estimation techniques suggest that the abortion rate in the Philippines is within the range of 20-30 induced abortions per 1000 women 15-49 years old, while the rate in Bangladesh is 26-30 per 1000 women. An estimated 400,000 abortions are performed each year in the Philippines; in Bangladesh, the annual number is approximately 730,000. In the Philippines, about 80,000 women are treated in hospitals each year for complications of abortion; in Bangladesh, 52,000 women are treated for abortion-related complications and another 19,000 receive hospital care for complications related to menstrual regulation procedures. Each year, 45% of pregnancies in Bangladesh and 53% of those in the Philippines are unwanted; only 18% and 16% of these pregnancies, respectively, are resolved through abortion, indicating a large unmet need for family planning services.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2310097.html.Article de périodique
Suffla S.
Experiences of induced abortion among a group of South African women
1997 - South African Journal of Psychology / Suid-Afrikaanse Tydskrif Vir Sielkunde, 27(4), p. 214-222
Mots clés : méthodologie; enquête; avortement; demande; soin post-abortum; psychologie; facteur psychologique; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; comportement
Pays / Régions : Afrique du Sud; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In-depth interviews were conducted with five single South African women 20-31 years of age of varying socioeconomic backgrounds who underwent illegal induced abortion before implementation in 1996 of the Choice on Termination of Pregnancy Act. The group included two students, a clerk, a factory worker, and a social worker. Of particular interest were the social context of the abortion decision, the abortion procedure itself, the psychological impact of the abortion, and perceptions of coping. Overall, the interviews indicated that the abortion decision is multidimensional and characterized by some degree of ambivalence. The decision to abort was based on lack of readiness to be a parent, financial hardships, pressure from the father, and fear of disapproval on the part of family members. The manner in which women responded to the abortion was a joint function of their psychological state and the social environment in which the procedure occurred. Although relief was the most common postabortion psychological response, feelings of guilt, shame, and loss also were present. Postabortion adjustment was positively influenced by the perception of support from one's partner. Further studies of this type are urged to help South African health providers to develop a framework for abortion counseling aimed at minimizing postabortion psychological distress.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 132529.Article de périodique
Mahomed K.; Healy J.; Tandom S.
Family planning counselling -- a priority for post abortion care
1997 - Central African Journal of Medicine, 43(7), p. 205-207
Mots clés : méthodologie; enquête; soin post-abortum; counseling; grossesse non prévue; grossesse non désirée; complication; contraception; méthode contraceptive; étudiant; scolarisation; programme planning familial; planning familial; clinique; hôpital; service de santé; programme; santé de la reproduction; fécondité; population; facteur démographique; contraception d'urgence; contraception postcoitale
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A prospective study of the 2050 women presenting to Harare and Parirenyatwa Hospitals in Harare, Zimbabwe, in 1992-93 with complications of incomplete abortion verified the importance of adequate postabortal family planning services. Mean age of study participants was 25.9 years; 83% were married or cohabitating. 1130 women (55%) acknowledged the pregnancy was unplanned. Only 94 (5%) admitted to induced abortion, however, and another 271 (13%) were noncommittal; 1369 women (67%) said the pregnancy became wanted over time. 1549 women (76%) were not using any form of contraception when the index pregnancy was conceived. The main reasons for nonuse of contraception were desire to become pregnant (53%) and disapproval of family planning (14%). As part of an International Project Assistance Services-funded intervention, family planning counselors were hired in 1993 to provide services at the same Zimbabwean sites where women with abortion complications are treated. The number of postabortal women accepting contraception increased from 49% before the intervention, when counseling was haphazardly provided, to 97% after implementation of the counseling program; 34% and 92%, respectively, actually left the hospital with some contraceptive method. These findings confirm the importance of offering women easily available contraceptive services after abortion, with the aim of preventing the need for future pregnancy terminations.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 131499.Rapport
Koffi N.G.; Fassassi R.
Fécondité et planification familiale au sein des corps habillés, militaires et paramilitaires
1997 - ENSEA, FNUAP, Abidjan, 155Résumé : La population des camps et cités militaires et para militaires d'Abidjan et de Bouaké, constituée par les gendarmes, les policiers et les militaires dont un échantillon a été enquêté, se caractérise au plan de l'âge par son extrême jeunesse : les individus de moins de 14 ans font environ 50 % de l'effectif total. Cette jeunesse se traduit au plan matrimonial par une forte proportion de jeunes célibataires mais aussi par une forme d'union non formelle, les unions libres, qui touchent une fraction importante de la population adulte. L'instruction touche la plupart de 1a population mais les différences entre les hommes et les femmes sont encore grandes puisque seulement 1 % des hommes sont analphabètes contre 12 % de femmes ne sachant ni lire ni écrire.Dans son ensemble, la fécondité masculine est assez élevée : le nombre moyen d'enfants par homme est de 10 enfants après 50 ans. L'indice synthétique de fécondité chez les femmes, révèle une fécondité moins élevée que sur l'ensemble du pays {3,4 contre 6,8 au niveau national). Mais l'âge assez faible des femmes au premier mariage (20,9 ans contre 18,6 ans au niveau national) et l'intervalle intergénésique qui semble se raccourcir dans les jeunes générations, sont de nature à s'opposer à la baisse rapide de la fécondité. Cependant, l'un des facteurs les plus influents dans le maintien d'une forte fécondité semble être la solidarité familiale et lignagère qui tisse un réseau d'entraide susceptible d'alléger à l'occasion une partie des charges parentales pouvant influencer la fécondité. Cette solidarité se traduit d'une part par une pratique importante de confiage d'enfants à des parents mais aussi par la présence relativement importante de personnes collatérales dans les ménages. Ainsi, le type de ménage le plus fréquent est la famille complète associant au noyau familial divers types de composants périphériques. Les avortements sont assez nombreux au sein de population féminine. Dans l'ensemble, 32,2 % des femmes ont eu recours à cette pratique qui apparaît comme un choix dramatique face à un manque d'information sur les possibilités qu'offrent les programmes actuels de planification familiale. On note d'ailleurs une forte approbation de la planification familiale par les femmes qui souhaitent, à l'occasion de cette enquête, diversifier leurs sources d'information et d'approvisionnement en moyens contraceptifs. Les taux de prévalence contraceptive des méthodes modernes sont relativement faibles (14,5 % pour la pilule, 27,2 % pour la méthode des cycles) mais les plus forts taux de prévalence se retrouvent dans la population des femmes non mariées. Le Sida et les autres maladies sexuellement transmissibles sont connus de la plupart des personnes enquêtées mais il semble que les informations, qui leur parviennent essentiellement à travers la télévision, ne soient pas comprises dans toutes leurs dimensions.
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Meekers D.; Calves A.E.
Gender differentials in adolescent sexual activity and reproductive health risks in Cameroon
1997
Mots clés : méthodologie; enquête; sexualité; adolescence; adolescent; avortement; sexualité premaritale; santé de la reproduction; risque; santé; population; facteur démographique; jeune; adolescent; âge; contraception d'urgence; contraception postcoitale; planning familial; comportement
Pays / Régions : Cameroun; Afrique Centrale; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : This paper examines gender differences in adolescent sexual behavior and reproductive health risks in Cameroon. Data were obtained from the 1996 Adolescent Reproductive Health Survey, a baseline survey conducted in the towns of Edea and Bafia. 55% of females and 70% of males were sexually experienced. The study examined gender differences in sexual initiation, unsafe sexual behavior, condom use, and sexually transmitted diseases and abortion. Explanatory variables included age, school enrollment, extent of discussion of sexual issues, views about females introducing condom use, and knowledge of sources of supply of condoms. Logistic techniques reveal that younger females were more likely than older females to have become sexually active by 15 years. Adolescents currently enrolled in school were less likely to have begun early sexual activity, particularly females. Females who discussed sexual issues with friends were more likely to initiate early sexual activity. 5% of females aged 12-17 years and 14% of males aged 12-17 years exchanged money or gifts for sex. A higher proportion of older adolescents had exchanges for sex. 5% of females aged 12-17 years and 16% of males aged 12-17 years had two or more regular sex partners. The proportion with multiple partners significantly increased with age. Around 40% of those aged 12-17 years had used condoms at least once. Condom use significantly increased with age. 9% of females aged 15-17 years and 20% of females aged 18-22 years had had an abortion. Risk of having a sexually transmitted disease in the previous year was higher for females among those with multiple casual partners and was higher for males with multiple regular partners.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 125627.Article de périodique
Calves A.E.; Meekers D.
Gender differentials in premarital sex, condom use, and abortion: a case study of Yaounde, Cameroon
1997
Mots clés : méthodologie; enquête; focus group; enquête; sexualité premaritale; sexualité; partenaire; préservatif; contraception; contraception; méthode contraceptive; sexualité; loi; genre; adolescence; adolescent; jeune; adolescent; santé de la reproduction; étudiant; scolarisation; collecte; comportement; méthodes barrières; contraception; planning familial; avortement; contraception d'urgence; contraception postcoitale; population; facteur démographique; âge; santé
Pays / Régions : Cameroun; Afrique Centrale; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Gender differentials in premarital sexual behavior and reproductive health risks were analyzed through use of survey data on 541 unmarried youth 15-26 years of age from the 1995 Yaounde (Cameroon) Family Formation Dynamics Study and a series of focus group discussions. By age 18 years, the vast majority of males and females are sexually active. 35.9% of females had a first sexual partner who was at least four years older and only 29% had a spontaneous first intercourse. Among adolescents 15-20 years old, 33% of females and 60% of males simultaneously had multiple sex partners; in the 21-26 year age group, these rates were 51% and 75%, respectively. 30% of females and 29% of males 15-20 years of age had exchanged sex for money or gifts; these rates were 41% and 37%, respectively, among older respondents. 22% of younger and 47% of older males reported sex with a prostitute. Among those age 15-20 years, 58% of females and 54% of males had used condoms at least once. These rates were 76% and 72%, respectively, among those 20-25 years old. Males primarily use condoms with commercial sex workers, to reduce the risk of sexually transmitted diseases, while Females mainly use condoms with partners with whom pregnancy is highly unwanted. Condom use with regular partners is low (20-30%). Finally, 18% of younger female respondents and 41% of the older respondents had had at least one abortion. Because of the age differential between most females and their male partners, female adolescents have limited ability to negotiate condom use. These findings should form the basis of the design of reproductive health programs for Cameroonian adolescents and young adults.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 127662.Article de périodique
Radhakrishna A.; Gringle R.E.; Greenslade F.C.
Identifying the intersection: adolescent unwanted pregnancy, HIV AIDS and unsafe abortion
1997
Mots clés : revue littérature; adolescence; adolescent; grossesse non prévue; grossesse non désirée; avortement; risque; psychologie; facteur psychologique; culture; VIH; sida; demande; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; planning familial; comportement; maladie; maladie; complication; facteur économique
Pays / Régions : AfriqueRésumé : This publication explores the intersection of three critically important issues that have a significant impact on women's reproductive health: adolescent sexuality, HIV/AIDS, and unsafe and/or coercive abortion. The goal of this publication is to serve as a tool to stimulate policy-level discussion that can assist in framing a future agenda for action that is based on a balanced appraisal of the cumulative, devastating effects on young women's lives of these issues.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 169971.Article de périodique
Faundes A.; Hardy E.
Illegal abortion: consequences for women's health and the health care system
1997 - Int J Gynaecol Obstet, 58(1), p. 77-83.
Mots clés : revue littérature; loi; santé; service de santé; mortalité maternelle; médecin; personnel de santé; viol; femme; avortement; contraception d'urgence; contraception postcoitale; planning familial; soin; mortalité; population; facteur démographique; personnel de santé; facteur socio-économique; facteur économiqueRésumé : Each year half of the 40-60 million abortions that are performed are illegal and/or performed in an unsafe manner. Thus, abortion accounts for 200,000 maternal deaths in developing countries annually. Treating women who had illegal abortions strains health systems, and the women face longterm morbidity and social disability. Abortion will continue to exist as long as women face unwanted pregnancies, and unwanted pregnancies will continue to occur until women gain the power to dictate their sex behavior. The severity of abortion consequences is minimized when abortion is legal and adequate services are available. Immediate consequences vary according to gestational age and the abortion setting, both of which depend upon the age and socioeconomic status of the woman. In India, abortion is legal, but legal abortion is difficult to access, so 90% of India's estimated 6.7 million annual abortions are carried out in unhygienic conditions. In countries where abortion is permitted in cases of rape or if the pregnancy endangers a woman's life, physicians must make judgements or must seek the approval of a judge. Most women who become pregnant after a rape in such countries resort to clandestine abortions. The public hospitals in Mozambique, however, interpret risk to the woman's life in the broad sense and offer safe abortions. As women's status in societies improves, the abortion rate will decrease and safety will improve. It is important to emphasize the actual implementation of current laws and to note that gynecologists and obstetricians should be sensitive to the suffering of women with unwanted pregnancies. Providing safe abortions to desperate women is not the same as promoting or even favoring abortion. Gynecologists and obstetricians can help create conditions where legal abortion is accessible to rape victims. Procedures should be developed to optimize implementation of prevailing abortion laws.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 126015.Article de périodique
Leigh B.; Kandeh H.B.S.; Kanu M.S.; Kuteh M.; Palmer I.S.; Daoh K.S.; Moseray F.
Improving emergency obstetric care at a district hospital, Makeni, Sierra Leone
1997 - International Journal of Gynecology Obstetrics, 59(SUPPL. 2), p. S55-S65
Mots clés : mortalité maternelle; santé; complication grossesse; traitement; soin; soin; hôpital; hospitalisation; avortement; risque; mortalité; population; facteur démographique; maladie; complication; service de santé; programme; médecine; contraception d'urgence; contraception postcoitale; planning familial; santé publique
Pays / Régions : Sierra Léone; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Sierra Leone, the Freetown/Makeni Prevention of Maternal Mortality (PMM) team, one of 12 multidisciplinary teams in the international PMM Network, focused on treatment of hemorrhage to prevent maternal mortality. The preintervention situation analysis revealed a lack of drugs in the hospital dispensary, an inadequate refrigeration system for blood storage, a nonfunctioning obstetric operating room, no means of communication between the hospital and its 56 peripheral health units (PHUs), and a lack of trained personnel. Low salaries at the hospitals led to low staff morale and inadequate treatment of patients. The interventions included hiring a new physician with obstetric skills, training all categories of hospital and PHU staff, providing round-the-clock coverage by training a second physician, renovating a previously unused maternity operating room, providing a standby generator, procuring drugs and supplies, adopting a policy of treatment before payment, and providing cash incentives to staff (from October 1993 through June 1994). Outside of the hospital, community motivators were trained to facilitate referral of women with pregnancy complications, and the transportation and communication system was improved. Meanwhile, civil war caused economic conditions to deteriorate and created large numbers of refugees. The project resulted in an increase in the number of women treated for complications from 31 in 1990 to 98 in 1995, a decrease in the case fatality rate (CFR) from 32% to 5%, an increase in cesarean sections from 2 in 1990 to 38 in 1995, and an increase in abortion-related procedures from 22 in 1990 to 444 in 1995. The cost of the intervention was US$39,000, with 41% from nongovernmental organizations and 13% from the government. It was concluded that women with obstetric complications will seek available hospital care, that government hospital services can be improved by building on exiting resources, that safe abortion services are needed in Sierra Leone, and that the obstetric CFR can be dramatically decreased.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 130698.Article de périodique
Odlind V.
Induced abortion--a global health problem
1997 - Acta Obstet Gynecol Scand Suppl, 164(43-45
Mots clés : avortement; mortalité maternelle; morbidité; grossesse non prévue; grossesse non désirée; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique; maladie; complication; santé de la reproduction; féconditéRésumé : This article discusses the problems of unsafe abortion globally. Maternal mortality from pregnancy-related causes is an estimated 500,000 women per year, of which 99% occurs in developing countries. An estimated 30-50% of all maternal deaths in Africa and Latin America and 20-25% of maternal deaths in Asia are due to induced abortion. This amounts to about 100,000-200,000 women per year dying of complications of induced abortion. Abortion-related deaths are a product of unsafe abortion procedures resulting in lacerations, bleeding, and/or infections. For every maternal death, 10-15 women suffer from pregnancy-related morbidity. This results in about 5-7.5 million women suffering from nonfatal health problems related to pregnancy and childbearing yearly. Morbidity related to induced abortion may result in disabilities such as infertility, genito-urinary problems, and/or chronic pain. Developing countries with limited health resources are faced with expensive emergency treatment and demands on facilities and personnel for abortion complications. A 1971 study in Egypt found that abortion complications consumed about 50% of the entire budget of one maternity hospital. Abortion laws vary by country. About 25% of women live in countries that prohibit abortion except in life-threatening circumstances. About 12% live in countries that prohibit abortion, except in cases of rape or life-threatening illness. About 23% of women live in countries where abortion is permitted for medical and social reasons. About 40% of women live in countries that legally permit abortion. Findings suggest that legally available abortion is a prerequisite for medically safe and early abortion. The risk of death is 25-250 times greater for a woman who undergoes an unsafe abortion in a developing country compared to a woman in a developed country. The most effective way of reducing unsafe abortion is to reduce unwanted pregnancy.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 127556.Chapitre d'ouvrage
Van Look P.
Induced abortion: a global perspective on a controversial issue
1997 - In O.B.a.A. Taylor (Ed.) New insights in gynecology obstetrics, Research and Practice, p. 184-191. London: The Parthenon Publishing GroupArticle de périodique
Davis D.S.
Legal trends in bioethics
1997 - J Clin Ethics, 8(3), p. 313-319
Mots clés : avortement; sida; éthiqueRésumé : no abstract
Source : source : J Clin Ethics.Congrès
Catteau C.
Les IVG à la Réunion
1997 - Actes du séminaire du 3 décembre 1996Séminaire, Saint-Denis (RE) 1996/12/03, Saint-Denis (RE), IADODR, p. 89-94 p.
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Fawcus S.; McIntyre J.; Jewkes R.K.; Rees H.; Katzenellenbogen J.M.; Shabodien R.; Lombard C.J.; Truter H.
Management of incomplete abortions at South African public hospitals
1997 - South African Medical Journal, 87(4), p. 438-442
Mots clés : enquête; complication; traitement; soin; hôpital; hospitalisation; service de santé; curetage; méthode; aspiration; méthode; antibiotiques; Anesthésie; étudiant; scolarisation; méthodologie; avortement; contraception d'urgence; contraception postcoitale; planning familial; soin; santé; facteur économique; intervention chirurgicale; méthode; intervention chirurgicale; médicament; méthode
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : To develop guidelines for the management of incomplete abortion in South Africa's public sector hospitals, a prospective review was conducted of all 803 such patients admitted to 56 randomly selected hospitals September 14-28, 1994. 61% were first-trimester abortions. 533 cases (66.4%) were classified as low severity, 149 (18.6%) as moderate severity, and 121 (15%) as high severity. 767 women (95.5%) were hospitalized for at least 24 hours. Evacuation of the uterus was achieved by sharp curettage in 726 cases (90.4%) and by manual vacuum aspiration (MVA) in 21 cases (2.6%). 601 women (74.8%) received general anesthesia. Antibiotics were prescribed for 396 women (49.3%) and blood transfusions were administered to 125 women (15.6%). Use of blood transfusion and antibiotics rose with increased severity, but 15% of those with serious infection received no antibiotics. Smaller hospitals (less than 500 beds) tended to keep patients longer, despite a lower rate of high-severity or second-trimester cases. Recommended, to make the management of uncomplicated incomplete abortion more cost-effective and efficient, are more widespread use of MVA and mild analgesia and/or sedation, rational prescribing of antibiotics and blood transfusion, and a move toward shortened hospital stays and day case outpatient procedures.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 122700.Article de périodique
Iloki L.H.; G'Bala Sapoulou M.V.; Kpekpede F.; Ekoundzola J.R.
Maternal mortality in Brazzaville (1993-1994)
1997 - Journal de Gynecologie Obstetrique et Biologie de la Reproduction, 26(2), p. 163-168
Mots clés : méthodologie; ville; résidence; mortalité maternelle; incidence; décès; risque; population; facteur démographique; mortalité; mesure
Pays / Régions : Congo; Afrique Centrale; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Hospital and morgue records and vital statistics were the basis for an estimation of the maternal mortality rate in Brazzaville and an assessment of the principal causes and associated risk factors. Information on deaths of women 15-44 years old occurring between May 1, 1993 and April 30, 1994 was sought in hospitals, the municipal morgue, and the vital statistics centers. 143 maternal deaths meeting the World Health Organization definition were identified among the 1021 deaths of women 15-44 years old. During the study period, 35,000 live births were registered. The maternal mortality rate was estimated at 408/100,000 live births. 37 deaths occurred in the first trimester, including 3 associated with ectopic pregnancies and 34 resulting from abortion complications. Maternal causes were the third main cause of death in reproductive-age women. 29.6% of deaths of women 15-44 were due to AIDS, 14.5% to respiratory infections including tuberculosis and pneumonia, and 14.0% to maternal causes. 30% of the women had no prenatal care. The principal direct obstetrical causes were hemorrhage (40.5%), postpartum septicemia (12.7%), postabortal septicemia (18.9%), and eclampsia (11.2%). AIDS was the main indirect cause, accounting for 4.2% of the deaths. Reduction of maternal mortality in Brazzaville will require improving prenatal care, preventing HIV infections, preventing illegal abortion, and equipping hospitals to provide emergency treatment.French Abstract: Les enregistrements d'hôpitaux et de morgues aussi bien que les statistiques vitales étaient à la base de l'estimation du taux de mortalité maternelle à Brazzaville et une determination des causes principales et des facteurs de risque associés. L'information sur les morts des femmes âgées entre 15-44 ans qui se sont produites du 1 mai 1993 au 30 avril 1994 a été recueillie des hôpitaux, de la morgue municipale, et des centres de statistiques centraux. 143 morts maternelles selon la définition de l'Organisation de la Santé Mondiale ont été identifiées parmi les 1021 morts de femmes âgées de 15-44 ans. Pendant la période de recherche, 35.000 accouchements vifs ont été enregistrés. Le taux de mortalité maternelle a été estimé à 408/100.000 accouchements vifs. Il y avait 37 morts pendant le premier trimestre, y compris 3 associées à la grossesse ectopique et 34 dûes aux complications de l'avortement. Les causes maternelles étaient la troisième plus importante cause de la mort parmi les femmes. 29,6% des morts parmi les femmes étaient des causes du SIDA, 14,5% étaient dûes à des infections respiratoires comme la tuberculose et la pneumonie, et 14,0% à des causes maternelles. 30% des femmes n'ont pas reçu de services prénataux. Les causes obstetriques directes les plus importantes étaient l'hémorragie (40,5%), la septicémie après l'accouchement (12,7%), la septicémie après l'avortement (18,9%), et l'éclampsie (11,2%). Le SIDA étant la cause principal indirecte, soit celle de 4,2% des morts. La réduction de la mortalité maternelle à Brazzaville nécessite une amélioration des services antenataux, une meilleure prevention d'infection avec le VIH, la prevention de l'avortement illégal, et des hôpitaux capables de fournir les dits traitements en cas d'urgence.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 126268.Article de périodique
Jacobs M.; Wigton A.; Makhanya N.; Ngcobo B.
Maternal, child and women's health: a South African innovation
1997 - South African Health Review, 139-152
Mots clés : revue littérature; santé enfant; jeune; adolescent; santé; femme; mortalité; loi; taux; service de santé; programme; âge; population; facteur démographique; avortement; contraception d'urgence; contraception postcoitale; planning familial; soin; facteur économique
Pays / Régions : Afrique du Sud; Afrique Anglophone; Afrique; Afrique Australe; Afrique SubsaharienneRésumé : This chapter will review some key developments in the sphere of Maternal, child, and women's health (MCWH) over the past year. While the government's national policies and plans provide the framework for the review, contributions from other players, such as academic and research institutions, and non-governmental bodies, are also recognised. (excerpt)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 173408.Article de périodique
Jewkes R.K.; Fawcus S.; Rees H.; Lombard C.J.; Katzenellenbogen J.M.
Methodological issues in the South African incomplete abortion study
1997 - Studies in Family Planning, 28(3), p. 228-234
Mots clés : méthodologie; enquête; échec; complication; étudiant; scolarisation; avortement; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; analyse
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In 1994, a national hospital-based study was undertaken of cases of incomplete abortion presenting to public hospitals in South Africa. Data were collected for all women admitted to a random sample of hospitals with incomplete abortion during a 2-week period. The WHO protocol for such studies was used as a basis for developing the methods to describe the epidemiology of incomplete abortion and hospital management of cases. Attempts were made to estimate the proportion of cases that might have been induced. This report focuses on methodological issues arising from the study that have implications for future research. The findings demonstrate that only a small proportion of the women acknowledged having had an induced abortion and that only a few of those who did showed evidence of interference with pregnancy. Clinical opinion of sepsis and the likelihood of induction were found to be highly unreliable. These findings considerably reduce the usefulness of the WHO-protocol method of estimating the likely origin of incomplete abortions. Results presented in terms of three partially overlapping descriptive categories are judged to better reflect the limitations of the data collected. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 127970.Article de périodique
Otsea K.; Baird T.L.; Billings D.L.; Taylor J.E.
Midwives deliver postabortion care services in Ghana
1997 - Dialogue, 1(1), p. 1-2
Mots clés : programme; sage-femme; personnel de santé; soin; traitement; soin; complication; soin post-abortum; rural; résidence; santé de la reproduction; personnel de santé; santé; contraception d'urgence; contraception postcoitale; planning familial; programme planning familial; population; facteur démographique; éducation
Pays / Régions : Ghana; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Postabortion care plays a critical role in reducing maternal morbidity and mortality in developing countries. Preliminary findings from Ghana's Mother Care Project suggest that midwives can be trained to provide safe, acceptable postabortion care to rural women. Hospital-based physicians, the traditional providers of emergency obstetric care, are concentrated in Ghana's urban centers while the country's 6000 midwives practice in health centers or private maternity homes in or near the communities where the majority of women live. A 1996 Mother Care operations research project evaluated the quality of postabortion services delivered by specially trained midwives. Baseline interviews revealed broad support among physicians and community leaders for the program, primarily because of its low cost and capability to increase accessibility to emergency obstetric services. They expressed concerns, however, that midwives receive regular supervision, that a functioning referral relationship be created between trained midwives and district hospitals, and that legal limits be defined. 40 professional public and private sector midwives and 4 doctors from referral hospitals participated in the initial 1-week training, which covered clinical skills related to identification and treatment of abortion complications with manual vacuum aspiration, stabilization and referral, pain management, infection prevention protocols, counseling, postabortion family planning, and follow up. Training doctors and midwives together created a climate of trust and respect. At one district hospital, half the postabortion cases in a 4-month period were treated by a midwife. Early monitoring visits confirmed that trained midwives were providing excellent postabortion care.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 133514.Article de périodique
Makinwa Adebusoye P.K.; Singh S.; Audam S.
Nigerian health professionals' perceptions about abortion practice
1997 - International Family Planning Perspectives, 23(4), p. 155-161
Mots clés : méthodologie; personnel de santé; perception; complication; coût; prévalence; soin; santé; psychologie; facteur psychologique; comportement; contraception d'urgence; contraception postcoitale; planning familial; mesure
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This study examines the perceptions of health professionals about abortion practice in Nigeria. The data are obtained from a 1996 survey among health professionals. The sample included 67 doctors, nurses, midwives, and chemists who were considered knowledgeable about abortion practices. 66% were from rural and urban areas of states in Nigeria. An effort was made to select chiefs of obstetrics and gynecology in major hospitals and clinics, private-practice obstetricians and gynecologists, government officials, representatives of women's groups, academics researching the subject, and activists in nongovernmental organizations. Results are presented for each of the 4 health zones in the northeast (18 persons), northwest (23), southeast (11), and southwest (15), or north and south regions. 51% of respondents were medical professionals, including 43% who were physicians and 8% who were nurses. 66% had abortion experience in the public sector, and 34% had experience in the private sector. 58% had experience in their practice in public hospitals, 32% had experience in private hospitals, and 22% had a private office practice. 33% had experience outside the workplace and in youth programs or counseling programs. Health care facilities are poorer and less available in rural areas, but about 50% had experience for 6 or more months in rural areas. 42% had medical degrees. Respondents believed that abortions were obtained from a physician, a midwife or nurse, traditional providers with no formal medical training, or were self-performed, using drugs or other means. About 66% of abortion users were expected to have suffered medical complications, and almost 20% were expected to have been hospitalized. Urban women and wealthy women were viewed as more likely to have had a safe abortion. The lowest cost of an abortion was estimated to be equivalent to the cost of one person's basic meals for 2 days.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/pubs/journals/2315597.html.Article de périodique
Lazarus E.S.
Politicizing abortion: personal morality and professional responsibility of residents training in the United States.
1997 - Social Science Medicine, 44(9), p. 417-425
Mots clés : éthiqueRésumé : Ever-increasing technological innovations surrounding birth are creating new challenges in biomedical ethics in U.S. obstetrics. The politicization of abortion has agumented these challenges and led to increased conflict between physicians' personal morality and professional responsibility. This paper focuses on some of the problems generated by abortion policies and procedures in an obstetric/gynecology residency program. Examples of conflicts among residents are presented to demonstrate the effect of pluralistic moral perspectives. A system is described where some residents will do abortions and some will not. Patients seeking abortion are often treated in an unprofessional manner when it appears that a conflict exists between the values of patients and those of residents. Unless the socialization of residents includes ethical training, defined educational policy and institutional direction, ethical dilemmas will lead to increased resident stress, an inadequate doctor-patient relationship and a continued shortage of physicians willing to perform abortions despite new policies called for in graduate medical education.
Source : Source : Social Science Medicine.Article de périodique
Taylor J.E.; Starrs A.; Baird T.L.
Postabortion care and safe motherhood in Ghana
1997 - Initiatives in Reproductive Health Policy, 2(2), p. 3
Mots clés : soin post-abortum; service de santé; santé; santé de la reproduction; complication; traitement; soin; soin de santé primaire; soin; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Ghana, a multidisciplinary Safe Motherhood Task Force complied a comprehensive Safe Motherhood plan that addresses such issues as policy, research, community education and involvement, materials development, and equipment supply. Development of this plan began after a 1993 consultative meeting called for creation of the task force. The task force met over the next year to develop clinical and health education guidelines for Safe Motherhood that included the management of abortion complications but failed to recommend that uterine evacuation be performed at the health center level. Meanwhile, another multidisciplinary group was developing a set of reproductive health service policies and standards that identified the key services that should be available at each level of the health system and the appropriate providers for each service. This group recommended that family planning nurses and midwives provide postabortion care, including uterine evacuation with manual vacuum aspiration. This policy was adopted by the Safe Motherhood Task Force, and the group began working on implementation issues such as funding for training and equipment needs related to postabortion care. Training of trainers workshops began in 1995, and the plan is now being implemented at the regional level. A study is also underway to determine the safety, acceptability, and feasibility of primary care midwives performing uterine evacuation.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 132751.Article de périodique
Ominde A.; Makumi M.; Billings D.L.; Solo J.
Postabortion care services in Kenya: baseline findings from an operations research study
1997
Mots clés : évaluation; demande; soin post-abortum; complication; counseling; contraception d'urgence; contraception postcoitale; planning familial; programme planning familial; service de santé; programme; attitude; psychologie; facteur psychologique; comportement; clinique; hôpital; service de santé
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The Population Council's Africa Operations Research and Technical Assistance Project II is collaborating with IPAS, the Kenyan Ministry of Health (MOH), and the Family Planning Association of Kenya on a project to evaluate 3 different models of linking emergency treatment of incomplete abortion and family planning services in 6 MOH hospitals. As part of a baseline survey conducted in 1996, 481 incomplete abortion patients and 140 providers were interviewed. The majority of abortion patients were parous married women 20-29 years old. While 56% of dilatation and curettage patients were treated within 12 hours of hospital admission, 38% of manual vacuum aspiration (MVA) patients waited more than 2 days for the procedure. 55% of abortion patients reported pain, yet only 19% were provided with some type of medication. Infection prevention practices showed serious deficiencies, especially in the reuse of MVA equipment. Few patients received information about the procedure or their return to fertility; in general, providers were perceived as judgmental and abrupt in their interactions with abortion patients. Only 22% of patients received postabortion family planning counseling. Few women returned for scheduled follow-up visits, presumably due to the poor treatment they received, stigma, distance to the facility, and problems leaving their job. On the basis of these findings, training in MVA and postabortion family counseling was undertaken at all 6 hospitals. Post-intervention data collection will take place in March-April 1997.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 123193.Article de périodique
Huntington D.; Nawar L.; Hassan E.O.; Youssef H.; Tawab N.A.
Postabortion case load in Egyptian hospitals
1997Résumé : In 1996, the Egyptian Fertility Care Society and the Population Council's Africa and Near East Operations Research/Technical Assistance Project conducted a study of 86 Ministry of Health and University Medical hospitals (15% of public sector hospitals) to determine the volume and nature of the postabortion caseload in public sector hospitals in Egypt. Egypt has a rather restrictive abortion policy. A medical record abstract form for all postabortion cases and a daily tally sheet for all obstetric/gynecologic (Ob/Gyn) admissions during a 30-day period were the data collection methods used. 19% of all Ob/Gyn admissions underwent treatment for abortion (miscarriage and induced abortions combined). These women were 20 to 50 years old. Spontaneous abortion accounted for 35% of the abortion cases. Induced abortion appeared to comprise the remaining cases (58% possibly induced, 5% certainly induced, 2% probably induced). About 61% of abortion patients had no formal education. The researchers estimated the abortion ratio for Egypt to be 14.75 abortions/100 pregnancies. About 56% of the postabortion patients lived more than 5 km away from the hospital. They were 26% more likely to suffer from severe hemorrhaging than those living closer to the hospital. 69% referred themselves to the hospital, a strong indication of a weak referral system for abortion complications from the primary health care system. Around 47% had ever used a contraceptive method. 17% were using a contraceptive method at the time of conception. About 42% aimed to use a contraceptive method during the postabortion period. The mean duration of hospital stay was 16.7 hours (range, 1-248 hours). Mean gestational age at time of abortion was 10.8 weeks (range, 2-28 weeks). 86% had a gestational age of 12 weeks or less. 95% of postabortion patients underwent dilatation and curettage. 56% received no pain control medication; 10% received no antibiotics; 52% received therapeutic antibiotics. About 3% of cases with signs of infection received no antibiotics. The case fatality rate was 0.43%. The findings will be used to improve postabortion care in Egypt.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 121677.Article de périodique
Anonymous
Postabortion case load study in Egyptian public sector hospitals. Final report
1997
Pays / Régions : EgypteRésumé : The number of women who present to Egyptian health facilities and hospitals with complications from incomplete abortion is not reported in the Ministry of Health's information system, hindering postabortion care program development. A cross-sectional analysis conducted in 86 of Egypt's 569 public-sector hospitals indicated that 4153 (19%) of the 22,656 obstetrics-gynecology admissions to these health facilities during the 30-day study period involved cases of incomplete abortion. 35% of these cases were classified as spontaneous abortion, 60% were possibly or probably induced, and 5% were certainly induced. Extrapolation of these data suggests that 336,000 women present for postabortion treatment at Egyptian public hospitals each year. The mean age of abortion patients was 27.43; mean parity was 2.61. Only 47% of these women reported ever-use of a contraceptive method. Although 42% reported an intention to commence contraceptive use after the index abortion, only half of them were provided with a method prior to hospital discharge. Abortion complications included infection (5%), trauma (1%), and severe bleeding (14%). The case fatality rate in the study period was 0.43/100 admissions. Only 3% of the 4071 patients who required surgery were treated with manual vacuum aspiration (MVA). Dilatation and curettage, under general anesthesia, was the principle surgical technique. These findings suggest a need to increase the availability of MVA and to strengthen linkages between postabortion care and family planning programs.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 122841.Article de périodique
Fourn L.; Fayomi E.B.; Zohoun T.
Prevalence of induced abortion and family planning in BeninPrevalence des interruptions de grossesse et de la regulation des naissances au Benin
1997 - Journal De Gynecologie, Obstetrique et Biologie De La Reproduction, 26(8), p. 804-808
Mots clés : tendance; prévalence contraceptive; source données; facteur géographique; âge; avortement; contraception d'urgence; contraception postcoitale; planning familial; contraception; méthode contraceptive; collecte; méthodologie; population; facteur démographique
Pays / Régions : Bénin; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Les dossiers de 190 des 205 centres de santé, hôpitaux, et cliniques privées au Bénin ont été analysés pour la période de cinq ans de 1990 à 1994 pour déterminer les prévalences de l'usage de la contraception et de l'avortement volontaire dans tout le Bénin. Les statistiques qui sont disponibles sur l'avortement ou sur le curettage et sur l'insertion des stérilets ont été compilées pour les 190 centres de santé. Des données sur la vente des produits anticonceptionnels aux cliniques de planning familial et aux centres de santé et par les équipes mobiles ont été utilisées pour indiquer l'usage d'autres méthodes. Pendant la période de cinq ans, 8186 cas d'avortements ont été rapportés. 80% de ces avortements étaient chez les femmes âgées de 15 à 25 ans. La prévalence générale était de 1,5 avortements par 1000 accouchements, allant de 1,4 par 1000 en 1990 à 1,8 par 1000 en 1994. La prévalence d'usage de la contraception s'est accrue de 4,7 par 1000 femmes d'âge reproductif en 1990 à 20,1 par 1000 en 1994. En 1994, le département de Zou avait le plus bas taux d'usage, 20 par 1000 femmes d'âge reproductif, pendant que le taux d'usage le plus élevé, de 31,1 par 1000, était à l'Oueme. La prévalence éstimée était en croissance dans tous les six départements pendant la période de cinq ans. Cependant, ces données devraient être soigneusement interprétées à cause de la possibilité de biais. Il paraît que les taux de tous les deux l'avortement et l'usage de la contraception sont en hausse.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 132368.Article de périodique
Okonofua F.E.
Preventing unsafe abortion in Nigeria
1997 - African Journal of Reproductive Health, 1(1), p. 25-36
Mots clés : revue littérature; complication; avortement; loi; mortalité maternelle; politique; programme; demande; complication grossesse; maladie; complication; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique; facteur économique
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Unsafe abortion accounts for 40% of maternal mortality in Nigeria, yet policy-makers fail to acknowledge the nature and severity of the problems caused by unsafe abortion. Experience in other parts of the world indicates that presentation of accurate information on abortion can lead to liberalization of abortion laws and development of policies to reduce the need for abortion. Because there is no accurate information or known intervention project to deal with abortion in Nigeria, this article presents a conceptual framework for abortion research that calls for: 1) documenting the incidence of septic abortion in Nigeria, 2) conducting formative and intervention studies to prevent unwanted pregnancy and unsafe abortion, 3) seeking ways to improve abortion care and liberalize abortion law, and 4) conducting research to improve postabortion family planning services. After considering each of these topics in detail, the paper concludes that such research is possible in Nigeria, and that, as long as abortion is unlawful, priority should be given to efforts to reduce unwanted pregnancy as well as to liberalize abortion law.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 122517.Article de périodique
Anonymous
Reducing unsafe abortion in Kenya
1997 - Population Briefs, 3(2), p. 2
Mots clés : hôpital; hospitalisation; complication; soin post-abortum; avortement spontané; fausse couche; counseling; service de santé; soin; santé; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; complication grossesse; maladie; complication; programme planning familial; clinique; hôpital; service de santé; programme; attitude; psychologie; facteur psychologique; comportement
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Kenya, where abortion is permitted only to save a woman's life, unsafe abortion accounts for over one-third of maternal deaths and hospital emergency rooms are overcrowded with women suffering complications of induced and spontaneous abortions. Postabortion care, a service linking emergency treatment of abortion complications with family planning counseling and comprehensive reproductive health care, is under review by the Population Council as a method of reducing maternal mortality and morbidity as well as the incidence of repeat unsafe abortion. An operations research study conducted by the Kenyan Ministry of Health identified several obstacles to such care: lack of information on abortion management, limited service provider skills, inconsistent supplies, and a lack of empathy for women presenting with incomplete abortion. Although 86% of abortion patients from 6 Kenyan hospitals expressed an interest in contraceptive counseling, only 5% reported actually receiving such information. As part of the operations research, these 6 hospitals introduced postabortion care, including, in 3 hospitals, use of manual vacuum aspiration. All 6 hospitals provided contraceptive counseling and psychosocial support. Based on the success of this experience, the Ministry of Health is considering introducing postabortion care to all hospitals in Kenya.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 126980.Congrès
Kulczycki A.
Religious system and abortion : representation and reality
1997 - Congrès International de la Population, Beijing, Chine, UIESP, 781-801 p.
Mots clés : religion
Source : source : Ceped.Article de périodique
Machungo F.; Zanconato G.; Bergstrom S.
Reproductive characteristics and post-abortion health consequences in women undergoing illegal and legal abortion in Maputo
1997 - Social Science and Medicine, 45(11), p. 1607-1613
Mots clés : méthodologie; enquête; loi; soin prénatal; histoire; santé de la reproduction; âge; contraception; méthode contraceptive; mortalité maternelle; étudiant; scolarisation; avortement; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin de santé primaire; soin; santé; fécondité; population; facteur démographique; mortalité
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : While abortion is illegal in Mozambique, increasingly liberal interpretation of the law has allowed hospitals to offer legal abortions. This study was undertaken to compare the characteristics of 103 women seeking care after an admittedly illegal abortion (in 13 women the attempt was unsuccessful) with 103 women undergoing legal abortion and a third group of 100 women receiving prenatal care. It was found that, compared to the other groups, the illegal abortion women were younger but had an almost equal number of pregnancies and of currently living children. The illegal abortion women experienced first intercourse and first pregnancy at a significantly lower age than the other women. The illegal abortion women also knew less than the other women about contraceptive methods and were far more likely to be never-users. While almost all women in the abortion groups expressed willingness to use contraception in the future, the illegal abortion women were less likely to express a method preference and more likely to seek contraception because they lacked a stable relationship with a male partner. Women undergoing legal abortion had no notable complications while those attempting illegal abortions suffered vaginal and cervical burns, endometritis-myometritis, severe anemia, uterine wall perforation, peritonitis, indication for hysterectomy, septicemia, and, in three cases, death. In 49% of cases, the patient had attempted to self-induce abortion, and in 38% the abortionist was a health care worker. The abortionists referred their patients directly to the hospital to avoid severe complications. More than 80% of the illegal abortion women did not know that safe abortion was available to them in the hospital in the first 12 weeks of pregnancy. High hospital fees also provide a barrier to abortion services for many women although it is clear that the legal abortions reduced associated risks significantly.
Source : Source : Social Science Medicine.Article de périodique
Liljestrand J.
Reproductive health beyond Cairo and Beijing
1997 - Acta Obstetricia et Gynecologica Scandinavica, 76(4), p. 291-293Résumé : The average number of children born per woman fell from 6.0 in 1960 to 3.8 in 1990, the largest decline ever in human fertility. During the same period, the child survival rate up to age 5 years increased from 78.4% to 89.3%, and average life expectancy increased from 46 to 62 years. Also over the same period, the level of primary school enrollment among 6-11 year olds rose from 48% to 77%. Understanding that fertility decline, infant mortality decline, and women's education are closely linked, it is clear that isolated efforts to provide contraceptive services in the absence of other major local development efforts have little chance of success. Both demographers and family planning organizations today share the view that reproductive health needs to be emphasized. The vast majority of the world's governments also agreed at the 1994 International Conference on Population and Development that a holistic approach to reproductive health is in countries' best interest, resulting in further declines in levels of child mortality and fertility.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 125801.Ouvrage
Tsui A.O.; Wasserheit J.N.; John G. H.
Reproductive health in Developing Countries. Expanding dimension, building solutions
1997 - Washington: New York Academic Press, 314 p.
Mots clés : santé de la reproduction; sexualité; violence; contraception; méthode contraceptiveRésumé : Abstract: This book contains the final report of the National Research Council's Panel on Reproductive Health in Developing Countries, which was organized in the aftermath of the 1994 International Conference on Population and Development to examine the degree of reproductive health problems in developing countries, assess the costs and effectiveness of interventions, and recommend programmatic and research priorities. The framework adopted by the panel holds that every sex act should be free from coercion and infection, every pregnancy should be intended, and every birth should be healthy. The panel, thus, concentrated on the causes, consequences, and remedies of health problems that are linked programmatically. The book opens with an extensive summary that is followed, in chapter 1, by an introduction. The framework is fleshed out in the next four chapters. Chapter 2 covers healthy sexuality through a discussion of the cultural context of sexuality, sexual violence, female genital mutilation, and policy and program implications. Chapter 3 considers infection-free sex and reproduction in light of the determinants and consequences of reproductive tract infections as well as interventions to prevent and treat these infections. The fourth chapter discusses intended births in terms of defining and measuring intended fertility, the consequences of unwanted pregnancies and births, the role of family planning and abortion services, and technical problems with measurements of fertility intentions and abortion. Chapter 5 looks at healthy pregnancy and childbearing through a consideration of maternal and infant death and disability and lessons for saving lives. The final two chapters link the interventions with a discussion of program design and delivery (chapter 6) and costs, financing, and prioritizing (chapter 7).
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 129399.Article de périodique
Nawar L.; Huntington D.; Hassan E.O.; Yousef H.; Abdel Tawab N.
Scaling-up improved postabortion care in Egypt: introduction to university and Ministry of Health and Population hospitals. Final report
1997
Mots clés : méthodologie; étude; demande; offre; praticien; prestataire; aspiration; méthode; Anesthésie; counseling; soin post-abortum; connaissance, attitude; pratique; CAP; étudiant; scolarisation; programme; avortement; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé; traitement; soin; éducation; clinique; hôpital; service de santé; programme planning familial
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : A pilot project implemented in 1994 sought to provide abortion providers at 10 hospitals in Egypt's Menia, Dakahlia, Alexandria, and Behira governates with training (a 5-day seminar followed by 4 months of on-the-job training) in use of manual vacuum aspiration (MVA) and local anesthesia as well as postabortion counseling. The intervention was evaluated through interviews with 1075 physicians and nurses and exit interviews with 1005 abortion patients. Physicians showed moderate improvements in technical knowledge about early complications and the return of fertility. The proportion of patients who reported they received friendly, supportive care increased from 56% in the pretest to 82% in the post-test. Nurses, who are in an ideal position to provide counseling and support, were underused, however. The intervention had a substantial effect on changing induced abortion practices. After the training, the percentage of women treated with dilatation and curettage dropped from 98% to 40% and general anesthesia use declined from 85% to 51%. Finally, the proportion of abortion patients who stated they intended to begin contraceptive use rose from one-third to one-half. To ensure a minimal level of training for future service providers, it is recommended that MVA training be incorporated into the medical education curriculum. Moreover, a mechanism must be introduced for the integration of family planning, postabortion, and other reproductive health care services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 128583.Congrès
Oosthuizen K.
Similarities and differences between the fertility decline in Europe and the emerging fertility decline in sub-Saharan Africa
1997 - International population conference = Congrès international de la population, Beijing 1997. Tome 3Congrès Général de l'IUESP, 23, Beijing (CN) 1997/10/11-17, Liège (BE), UIESP, p. 1063-1090 p.
Mots clés : contraception; méthode contraceptive; éducation
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Machungo F.; Zanconato G.; Bergstrom S.
Socio-economic background, individual cost and hospital care expenditure in cases of illegal and legal abortion in Maputo
1997 - Health and Social Care in the Community, 5(2), p. 71-76
Mots clés : enquête; grossesse; demande; coût; soin prénatal; facteur socio-économique; étudiant; scolarisation; méthodologie; population; facteur démographique; avortement; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin de santé primaire; soin; santé; facteur économique
Pays / Régions : Mozambique; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : A study carried out in Mozambique sought to develop a socioeconomic profile of women being treated for illegal abortion, undergoing legal abortion, and receiving prenatal care, and to determine the hospital and individual costs associated with each type of abortion experience. Data were collected from 103 women undergoing legal abortion (abortion is legally available on demand for up to 12 weeks of pregnancy) in Maputo Central Hospital, 103 women seeking outpatient care for "miscarriage" who admitted undergoing an illegal abortion, and 100 women receiving prenatal care. Statistical analysis of the data indicated that the women who resorted to illegal abortion were younger than those seeking legal abortion or receiving prenatal care and more likely to be living without a husband. Only 38 of the women with illegal abortion completed secondary school as compared to 70 of the women undergoing legal abortion and 96 of the prenatal care clients. The household income of the women seeking illegal abortion was also lower than that of the other groups (less than half that of the women undergoing legal abortion). Most of the study population was Roman Catholic, including 36 women who underwent illegal abortion, 59 who had legal abortions, and 20 who had prenatal care. The fact that average direct cost to patients for illegal abortion (14 contos) was much less than for legal abortions (46 contos) is partly due to the 46 cases of self-induced illegal abortion. The public costs of hospital care was also higher among the illegal group. These findings imply that the availability of legal abortion should be communicated widely and that the cost of legal abortion should not create a barrier for poor women.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 122671.Article de périodique
Kabira W.M.; Gachukia E.W.; Matiangi F.O.
The effect of women's role on health: The paradox
1997 - International Journal of Gynecology Obstetrics, 58(1), p. 23-34
Mots clés : genre; femme; santé; soin; éducation; facteur socio-économique; culture; santé de la reproduction; excision; mariage; état matrimonial; mariage; sida; VIH; violence; comportement; facteur économique; nuptialité; état matrimonial; mariage; maladie; maladie; complication
Pays / Régions : AfriqueRésumé : This article explores the paradox presented by the fact that the patriarchal nature of society in Africa dictates that women are at once entrusted with the responsibility of delivering health care to their families and at the same time denied the right to influence health policy. The introduction reviews the impact of traditional development theories built on the concept of motherhood and then presents the paradox and lists its ramifications. The next section of the paper considers women's health and its impact on Africa's health status through an exploration of such topics as recommendations of international conferences about women's health concerns, factors (including educational status) that affect women's health in Africa, sociocultural factors (including early marriages and female genital mutilation), reproductive health problems caused by female genital mutilation, early marriages, polygamy and widow inheritance, HIV/AIDS, and violence against women. Section 3 presents recommendations for developing a new social ethos that recognizes equality between the sexes and the differing needs of men and women. Fundamental changes to bolster the role of African women role in promoting health include 1) recognizing women's role as health providers, 2) promoting women's participation at higher levels in health institutions, 3) providing gender awareness education, 4) promoting women's economic independence, 5) using women's organizations to promote health, 6) involving women in health policy formulation, 7) promoting women's participation at all levels of leadership, and 8) dismantling the patriarchy.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 126010.Article de périodique
Rees H.; Katzenellenbogen J.M.; Shabodien R.; Jewkes R.; Fawcus S.; McIntyre J.; Lombard C.J.; Truter H.
The epidemiology of incomplete abortion in South Africa. National Incomplete Abortion Reference Group
1997 - S Afr Med J, 87(4), p. 432-437.
Mots clés : complication; avortement spontané; fausse couche; mortalité maternelle; morbidité; hôpital; hospitalisation; service de santé; avortement; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; mortalité; population; facteur démographique; soin; santé; facteur économique
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Morbidity and mortality associated with incomplete abortion were investigated in a prospective study of all 803 women who presented to 56 randomly selected public hospitals in South Africa with spontaneous or illegally induced abortion at under 22 weeks' gestation during a 2-week period in 1994. The mean age of study subjects was 27.7 years and median parity was 1; 66.8% were unmarried and 84% were Black. According to the clinical judgment of the admitting doctors, 38.7% of women were in the second trimester. Only 53.5% had ever used contraception. 60 women (7.5%) had definitely induced their own abortion. Adjustment for sampling suggested that 44,686 (95% confidence interval (CI), 35,633-53,709) women are admitted to South African public hospitals each year with incomplete abortion. If middle- and high-severity cases in this sample are used as indicators of unsafe abortion, these data suggest that 12,847 South African women each year have unsafe abortions. 15% (95% CI, 13-18) of patients have severe morbidity, while an additional 19% (95% CI, 16-22) experience moderate morbidity. Three maternal deaths occurred during the 2-week study period, suggesting a total of 425 maternal deaths (95% CI, 78-735) in public hospitals per year associated with incomplete abortion (maternal mortality rate, 37/100,000 live births). Unsafe incomplete abortion is a serious health problem in South Africa that significantly strains overstretched health services and budgets.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 122698.Article de périodique
Lema V.M.; Mtimavalye L.A.; Thole G.C.; Mvula M.T.
The impact of the manual vacuum aspiration (MVA) technique on health care services at Queen Elizabeth Central Teaching Hospital, Blantyre, Malawi
1997 - South African Medical Journal, 87(2), p. 218-224
Mots clés : méthodologie; aspiration; méthode; complication; risque; service de santé; programme; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé publique; santé; soin
Pays / Régions : Malawi; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A prospective descriptive study was conducted at Queen Elizabeth Central Teaching Hospital in Blantyre, Malawi to assess the impact of the manual vacuum aspiration (MVA) technique on health care services and its acceptability to patients and staff. The study was conducted from January 10 to April 9, 1994 among 456 patients who had MVA for treatment or investigation, the nurses and doctors working in the unit and hospital administrators. The main outcomes included in the study were the proportion of incomplete abortion patients who had MVA, the need for pain relief, patients' reactions, staff opinion, and reduction in ward occupancy rates and duration of hospitalization. 81.2% of the patients were treated for incomplete abortion. Of these, 97.4% had MVA for treatment of incomplete abortion. Only 10.7% of the patients required pain relief. In the gynecology ward, bed occupancy rates dropped from an average of 150% to 130% after the introduction of MVA. The mean hospital stay was reduced from 3 to 2 days with 52% staying for <24 hours. There were no major complications associated with the procedure. The findings show that MVA is a safe, reliable, effective and acceptable method of treating incomplete abortion, and can conserve hospital resources.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 161711.Article de périodique
Singh S.; Sedgh G.
The relationship of abortion to trends in contraception and fertility in Brazil, Colombia and Mexico
1997 - International Family Planning Perspectives, 23(1), p. 4-14
Mots clés : méthodologie; enquête; taux; transition fécondité; déterminant fécondité; étudiant; scolarisation; avortement; contraception d'urgence; contraception postcoitale; planning familial; contraception; méthode contraceptive; fécondité; population; facteur démographique
Pays / Régions : Mexique; Amérique du Nord; Amérique; Amérique Latine; Amérique du SudRésumé : National and regional estimates of the incidence of induced abortion in Brazil, Colombia, and Mexico from the late 1970s to the early 1990s indicate a clear rise in the abortion rate in Brazil and increases in the abortion ratio in all three countries. Crosssectional analysis showed no significant correlation between the abortion rate and contraceptive use, except in Mexico in the early 1990s, where a strong positive association was observed. Longitudinally, the abortion rate increased as contraceptive use increased in most regions of Brazil and Mexico throughout the study period, and in parts of Colombia until the mid-1980s. In Colombia and the most urban region of Mexico, the abortion rate declined as contraceptive use stabilized or increased. The abortion ratio was positively associated with contraceptive use over time in nearly every region of each country. The role of abortion in fertility decline was greatest in Brazil, where the general fertility rate would have been nearly 13% higher in the early 1990s if the abortion ratio had not increased from its level in the late 1970s. Abortion tended to have a greater impact on fertility in regions where contraceptive use was low. Overall, contraceptive use appears to have been a more important determinant of fertility than abortion, but abortion has played an important subsidiary role in determining fertility levels and trends in these countries. (author's)
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.guttmacher.org/pubs/journals/2300497.html.Article de périodique
James W.H.
The validity of inferences of sex-selective infanticide, abortion and neglect from unusual reported sex ratios at birth
1997 - European Journal of Population, 13(2), p. 213-217
Mots clés : avortement; infanticide; foeticide; mesure; méthodologie; sexualité; population; facteur démographique; famille; collecte; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In a 1995 study, Clark et al. report the births of 2429 boys and 2629 girls during 1956-91 in a group of Tonga speakers. The authors then extrapolated from Visaria's 1967 review of sex ratios from birth indicating the existence of a natural Black sex ratio at birth of 102 boys for every 100 girls to calculate that 250 boys had not been reported. These boys, however, may never have existed. One cannot infer present-day sex-related infanticide or induced abortion from present unanalyzed reported birth sex ratios in any society. That is the case because present sex ratios at birth are almost certainly dependent upon past sex prejudice, which is unquantifiable. Reporting bias and/or infanticide may be partly responsible for the deficit of boys in Clark et al.'s data, but other factors could also be responsible for the deficit. Sex ratios at birth and sex prejudice, and sex ratios at birth and polygyny are discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 129713.Article de périodique
Billings D.L.; Baird T.L.; Ankrah V.; Taylor J.E.; Ababio K.P.; Ntow S.
Training Ghanaian midwives in postabortion care: strategies for improving access and quality of services
1997
Mots clés : sage-femme; personnel de santé; soin post-abortum; avortement; personnel de santé; soin; santé; programme planning familial; planning familial; éducation; service de santé; programme; contraception d'urgence; contraception postcoitale
Pays / Régions : Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Unsafe abortion significantly contributes to high rates of maternal mortality and morbidity in Ghana. Hospital-based studies report that about 22% of all maternal deaths in the country are the result of unsafe abortion. In response, the Ministry of Health of Ghana has taken steps by integrating postabortion care (PAC) into its National Safe Motherhood Program and identifying midwives as appropriate providers of PAC services in its 1996 National Reproductive Health Service Policy and Standards. One of its activities has been the Ghana MotherCare operations research project, which involved the training of midwives on PAC, as well as manual vacuum aspiration. Immediately after training, participants engaged in community education. Overall, the project has revealed support for equipping midwives with the skills necessary to offer safe and comprehensive PAC services to women with abortion complications. Training midwives in PAC is one important strategy being implemented, ensuring that women suffering the effects of unsafe abortion are able to have easier access to life-saving care, as well as contraceptive services which will help break the cycle of unwanted pregnancies.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 147195.Article de périodique
Ankomah A.; Aloo Obunga C.; Chu M.; Manlagnit A.
Unsafe abortions: methods used and characteristics of patients attending hospitals in Nairobi, Lima, and Manila
1997 - Health Care for Women International, 18(1), p. 43-53
Mots clés : méthodologie; enquête; loi; demande; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Kenya; Pérou; Philippines; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Amérique du Sud; Amérique; Amérique Latine; Asie du Sud Est; AsieRésumé : Interviews with 626 women treated in 1993 for complications of unsafe abortion at five hospitals in Nairobi (Kenya), Lima (Peru), and Manila (Philippines) revealed marked differences in their demographic characteristics. The percentage under 25 years of age was 26% in Manila, 45% in Lima, and 91% in Nairobi. 84% of abortion patients in Nairobi were single compared with 77% in Manila and 21% in Lima; 77% of women in Nairobi had no children compared with 29% in Lima and 11% in Manila. In general, Nairobi abortion seekers tended to be young women who migrated to the city and were concerned pregnancy would impede their social mobility. In Lima and Manila, abortion was sought to limit births within union, generally for financial reasons. Never-use of contraception was reported by 80% of Kenyan women, 65% of Manila women, and 48% of those in Lima. When presented with 11 scenarios that might justify an abortion, the only indication the majority in all three cities supported was pregnancy resulting from rape. Women reported use of abortifacient agents such as livestock droppings, drinking chemicals and detergents, herbal medicines, and overdoses of over-the-counter medications, as well as insertion of sharp objects into the uterus. 98% of Kenyan respondents compared with 36% in Peru and 24% in the Philippines claimed illegal abortion was common; 92%, 75%, and 35%, respectively, were aware of at least one woman who died after an unsafe abortion. All of the women in Kenya and 89% in the Philippines reported it was difficult or very difficult to obtain an abortion; most were obtained through a secret referral system and involved unsanitary conditions. These findings indicate a need for postabortion family planning counseling as well as scrutiny of existing abortion laws and policies.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 121996.Article de périodique
Huntington D.; Nawar L.; Abdel Hady D.
Women's perceptions of abortion in Egypt
1997 - Reproductive Health Matters, 9), p. 101-107
Mots clés : méthodologie; perception; attitude; avortement; croyance; soin post-abortum; soin; évaluation; psychologie; facteur psychologique; comportement; contraception d'urgence; contraception postcoitale; planning familial; culture; santé de la reproduction; santé
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : During May-June 1995, a study was undertaken in Egypt to gather information on women's perceptions about abortions as a preliminary step in the development of appropriate postabortion counseling and medical care procedures. Data were gathered from in-depth interviews with 31 women hospitalized for postabortion complications, from focus groups discussions with two small groups of women attending family planning clinics, and from a small focus group of noncontracepting rural women. The average age of the abortion patients was 29 years, they had minimal or no formal education, they were all married, they had an average of three children, most were housewives, and only a third had ever used contraception. While none admitted to inducing abortion, information they provided allowed the events to be classified as spontaneous (14 women), possibly induced (10), or probably induced (7). The women reported being in intense pain, suffering from the shock of blood loss, being apprehensive about the use of a contraception during a 40-day postabortal period, and being concerned about fulfilling their household responsibilities in their weakened state. During their recovery, the women believed that they would need (but probably not receive) help with physical duties and emotional support. Most of the women expressed ambivalence about the abortion and miscarriages and considered the fetus a potential, rather than an actual, child. It was concluded that postabortal medical care should include attention to the physiological causes of pain and that counseling should seek stress reduction. Women need information on the causes and sequelae of miscarriage, and families must understand women's needs for rest and recuperation. Programs should help women understand their postabortion family planning needs and the feasibility of depending upon postabortion abstinence.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.
1995Article de périodique
Fawcus S.; Mbizvo M.T.; Lindmark G.; Nystrom L.
A community-based investigation of avoidable factors for maternal mortality in Zimbabwe
1996 - Studies in Family Planning, 27(6), p. 319-327.
Mots clés : enquête; mortalité maternelle; décès; ville; résidence; rural; résidence; étudiant; scolarisation; méthodologie; mortalité; population; facteur démographique
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A community-based investigation of maternal deaths was undertaken in a rural province (Masvingo) and an urban area (Harare) of Zimbabwe in order to assess their preventability. Avoidable factors were identified in 90 percent of the 105 rural deaths and 85 percent of 61 urban deaths. Delay in seeking treatment contributed to 32 percent and 28 percent of rural and urban deaths, respectively. Lack of transportation delayed or prevented access to healthy facilities in the rural area, a major problem in 28 percent of the cases studied. Suboptimal clinic and hospital management was identified in 67 percent and 70 percent of rural and urban deaths, respectively. Lack of appropriately trained personnel contributed to suboptimal care. In both settings, the severity of patients' conditions was frequently unrecognized, leading to delays in treatment and referral, and inadequate treatment. Appropriate community and health-service interventions to reduce maternal mortality are discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 121063.Article de périodique
Mirembe F.M.
A situation analysis of induced abortions in Uganda
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 79-80
Mots clés : revue littérature; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Uganda has a total fertility rate of 7.3 children per woman and a population growing at the annual rate of 2.8%. The government is actively promoting family planning on primarily a health basis. In Uganda, abortion is illegal except to save a mother's life. Despite such legislation, however, both induced and spontaneous abortion occurs in Uganda even when a mother's life is not in jeopardy. The rate of induced abortion is increasing, as evidenced by the growing rates of maternal mortality related to abortions registered in Ugandan hospitals. Research indicates that the majority of all induced abortions were among young, single, low parity women, most often in secondary school or university. A 1992 study by Bazira found the following reasons among women for terminating pregnancy: 50% did so out of a desire to continue their education, 25.7% feared their parents, 8.3% could not afford to care for a child, 3.0% had a spouse who did not want a child at that time, and 5.3% had completed their families. There is a low prevalence of contraceptive use among women who seek induced abortion, with lack of knowledge about contraception and the unavailability of contraceptives being the two main reasons for nonuse of contraception. Sepsis and hemorrhage comprised 60% of complications resulting from induced abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 114147.Article de périodique
Kulczycki A.; Malcom P.; Allan R.
Abortion and fertility regulation
1996 - Lancet, 347(june, 15), p. 1663-1668
Mots clés : taux; avortement; culture; facteur politique; mortalité maternelle; grossesse non prévue; grossesse non désirée; loi; politique; programme; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique; santé de la reproduction; féconditéRésumé : This article presents a review of abortion-related issues that suggests that worldwide abortion will remain a form of fertility regulation. It is estimated that about 2 in 10 maternal deaths occur worldwide due to unsafe abortion practices, which are mostly in developing countries and in countries where abortion is illegal. The 1994 International Conference on Population and Development was the first forum to focus in a global way on the serious health threat to women from unsafe abortion. In the US, about 60% of all pregnancies are unwanted or mistimed and about 50% are aborted. In most European countries, about 66% of women had at least one unintended pregnancy. The annual worldwide abortion rate is estimated to range from 32 abortions/1000 women to 46/1000 women aged 15-44 years. In most developed countries the abortion rate varies from 1 to 30/1000. The Netherlands has the lowest rate (5/1000) and the most liberal abortion laws. The former USSR has the highest rate (112/1000), although some central regions of European Russia have a higher rate of 186/1000. Variation in abortion rates by country can be accounted for by contraceptive prevalence and use-effectiveness, prevailing fertility preferences, laws and policies relating to abortion and contraception, and the relationship between abortion and contraception. Contraceptive usage is a key factor. For example, in the US, 7% of sexually active women aged 15-44 years, who were not using contraception nor seeking to become pregnant, accounted for 53% of unintended pregnancies. Developing countries shifting from high to low fertility may experience a rise in abortions. Where contraceptives are unavailable to adolescents, abortion rates are high and increasing. Women seek abortion for many reasons. Abortion laws vary widely by country. Vacuum aspiration is considered the safest, simplest, and most medically and economically effective way of inducing first-trimester abortions or treating incomplete abortions. The issue of abortion is complicated by political, religious, and moral concerns.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 114465.Article de périodique
Rylko Bauer B.
Abortion from a crosscultural perspective: An introduction
1996 - Social Science and Medicine, 42(4), p. 479-482Résumé : no abstract
Source : Source : Social Science Medicine.Article de périodique
Johansson A.; Nham T.L.T.; Lap N.T.; Sundström K.
Abortion in context: Women's experience in two villages in Thai Binh province, Vietnam
1996 - International Family Planning Perspectives, 22(3), p. 103-107Résumé : The government of Vietnam adopted a two-child policy in the 1980s to curb population growth; Vietnam now has one of the highest abortion rates in the world. In rural Thai Binh Province, where some local authorities strictly enforce the national population policy through a system of financial incentives and disincentives, 114 abortions occurred for every 100 births in 1991. A survey in two villages in Thai Binh among 228 women who had abortions that year revealed that contraceptive choice was limited; the IUD was essentially the only modern method used, and many women had given it up because of side effects. On average, the women had had 2.4 live births and 1.5 abortions, most of which took place before eight weeks of gestation. The most frequent reasons for choosing an abortion were wanting to save money and to avoid being fined for exceeding the two-child limit. Husbands were the most important persons in sharing the abortion decision; parents and parents-in law often did not agre e with the decision. Postabortion counseling was absent or inadequate. The village where the national population policy guidelines were more stringently enforced had twice the abortion ratio of the village where enforcement was more lenient.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2210396.html.Article de périodique
Gikaru L.; Kinoti S.N.; Gaffikin L.; Brace J.
Addressing complications of unsafe abortion in sub-Saharan Africa: programme and policy actions
1996
Mots clés : complication; loi; santé de la reproduction; offre contraception; politique; programme; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé; contraception; méthode contraceptive
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : A study coordinated by the Commonwealth Regional Health Community Secretariat for East, Central, and Southern Africa confirmed that unsafe abortion is a major cause of morbidity and mortality in sub-Saharan Africa and a formidable obstacle to social and economic progress. This report highlights the study's major findings (presented in full in the monograph "Complications of Unsafe Abortion in Africa") regarding the magnitude of unsafe abortion, clinical and cost-related issues, contraceptive use, men and unsafe abortion, and the legal context. It further suggests proposals for donors and development partners. Action is needed to decentralize emergency treatment services by providing equipment, staff, training, and supplies at the lowest level of the health care system. Community awareness of the magnitude of the unsafe abortion problem needs to be increased. Administrative and legal reforms are required to emphasize women's reproductive health rights in the treatment and management of unsafe abortion. The elimination of restrictions on the provision of family planning information and contraception, especially to adolescents, will help avoid unwanted pregnancy. Donors and development partners can provide support in the areas of technical assistance, strengthening family planning services, public awareness, support to community groups, capacity building through information and training support, monitoring and evaluation, and research activities.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 128568.Article de périodique
Sai F.
An overview of unsafe abortion in Africa. Foreword
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 2-3
Mots clés : complication; mortalité maternelle; morbidité; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique; maladie; complication
Pays / Régions : AfriqueRésumé : This overview of unsafe abortion in Africa indicates some reforms such as the provision of family planning services close to maternity units or hospitals where women can go for treatment of abortion. Medical students should learn how to perform a safe abortion and to manage incomplete abortions. Modern technology should be available for performing abortions. Abortion law should be examined from the medical and social perspective. The International Planned Parenthood Foundation's Strategic Plan, Vision 2000, in 1978, made the aforementioned recommendations and suggested that action be taken by family planning associations. This article refers to a number of studies that suggest a high rate of maternal mortality related to abortions performed under unsterile and unsafe conditions. Unsafe abortions may be performed by private doctors, traditional healers, or midwives. Unsafe practices include the insertion of IUDs or plastic cannulas or sticks and plants into the cervix. Women may resort to ingestion of unsafe products such as gasoline and other toxic substances in order to induce an abortion. Induced abortion rates among school girls is estimated to be high. There are health risks and health resources are strained from unsafe abortion. Most of the empirical studies of unsafe abortion are conducted in hospitals. Ironically, laws against abortion in Africa are the inheritance from colonial regimes that long ago abolished anti-abortion laws. The medical community is urged to respond with reason, moral sensibility, and social responsibility.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 114148.Article de périodique
Orobaton N.
Are unsafe induced abortions contributing to fertility decline in Africa? Findings from Egypt and Zimbabwe
1996 - Demography India, 25(2), p. 261-274
Mots clés : méthodologie; transition fécondité; avortement; taux; santé; fécondité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Zimbabwe; Egypte; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Afrique du Nord; Pays arabes; Pays MéditerranéensRésumé : This study tests whether total abortion rates remained constant between two years in Egypt and Zimbabwe and whether total abortion rates had additional effects on contraceptive prevalence rates in the Target Cost Model developed by Stover et al. (1993) in the Futures Group. Data were obtained from the 1988, 1992, and 1994 Demographic and Health Surveys for Egypt and Zimbabwe. The proportion needing to use contraceptives declined by 0.8 percentage points due to a 1.1 percentage point reduction in the proportion of married women in Zimbabwe. The median postpartum infecundability increased by a half a month during 1988-94 and was associated with a decline in the need for contraceptive use by 0.7 percentage points. The percentage of women aged 45-49 years who were childless declined by 2.3 percentage points and was associated with an increased need for contraceptive use of 1.6 percentage points. Proximate determinant changes led to little change in fertility decline. In Egypt, the percentage of married women increased by 0.2 percentage points and was associated with a 0.1 percentage point increase in needed contraceptive prevalence. The median duration of postpartum infecundability decreased by 3.1 percentage points and increased the needed contraceptive prevalence rate by 5.6 percentage points. Sterility did not change during 1988-92. The changes in proximate determinants in Egypt showed a reduction in their fertility inhibiting effects. Contraceptive prevalence was expected to be 52.5% in Egypt with a target total fertility rate of 3.9 in 1992 and 55.2% in Zimbabwe with a target fertility rate of 4.3 in 1994. Actual prevalence was lower by 5.4% in Egypt and 7.1% in Zimbabwe. Findings suggest that fertility declines were due to increases in the abortion rates.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 126466.Article de périodique
Johnston H.B.; Hill K.H.
Avortement provoqué dans le monde en développement: estimations indirectes
1996 - International Family Planning Perspectives, N° spécial(15-25
Mots clés : enquête démographique et de santé; EDS; prévalence contraceptive; enquête; population; facteur démographique; planning familial; contraception; méthode contraceptiveRésumé : To enable donor agencies and family planning program managers to estimate future needs for contraceptive supplies in developing countries, data drawn from 106 Demographic and Health Surveys and Contraceptive Prevalence Surveys conducted in 35 Third World countries between 1974 and 1992 were reviewed. At least 2 surveys, conducted a minimum of 2 years apart, were used to permit calculation of changes in total and method-specific prevalence and annual rates of change. At the time of the most recent survey, 44% of respondents were using contraception and 35.5% were using a modern method; these rates were 31.6% and 24.0%, respectively, at the initial survey. Total contraceptive prevalence increased at an annual rate of 5%, while modern method use increased by 6%. Sterilization acceptance increased by 8% each year, while use of the pill, IUD, and condom registered annual increases under 2%. In 30 of the 33 countries for which data were available, the prevalence of sterilization grew at a substantially faster rate than that of other modern methods. Overall, these findings suggest a need for caution against unrealistically high forecasts of the demand for supply-based contraceptive methods. On the other hand, the population group eligible for contraception is increasing by 2-3% each year. It remains uncertain whether the increased availability of injectables and implants will result in greater overall contraceptive prevalence or simply substitute for pill, IUD, and condom use
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/journals/ifpp_archive.html.Article de périodique
Adu S.A.
Biosocial profile of women with incomplete abortions in Ga-Rankuwa Hospital, Medunsa, RSA
1996 - Cent Afr J Med, 42(7), p. 198-202.
Mots clés : complication; facteur économique; épidémiologie; psychologie; facteur psychologique
Pays / Régions : Afrique du SudRésumé : OBJECTIVES: 1. To obtain information on the nature and extent of the problems of incomplete abortion in Ga-Rankuwa Hospital. 2. To gain a better understanding of women's attitudes regarding abortions in the Ga- Rankuwa community. 3. To identify the predominant biosocial factors that might influence outcome, morbidity, mortality, management and cost among those who induce abortion. The study highlights the importance and relevance of the abortion issue particularly in RSA where abortion is about to be legalized. Whether the legalization will decrease morbidity and mortality associated with criminally induced abortions remains to be established. The study also shows that those who induce abortion are worse off in terms of morbidity and other sequelae as well as cost to the health care system. Strategies for reducing the rate of abortion have been discussed.
Source : source : Cent Afr J Med.Article de périodique
Abebe G.M.; Yohannis A.
Birth interval and pregnancy outcome
1996 - East African Medical Journal, 73(8), p. 552-555
Mots clés : complication
Pays / Régions : EthiopieRésumé : A cross-sectional study was conducted from September to March 1993 at maternity ward of Jimma Hospital to asses the pattern and determinants of birth interval and the role of contraceptive in influencing the length of birth interval. The information was collected by use of pre-tested questionnaire from 415 mothers by three midwives trained for this purpose. The variables examined were: information on parity, use of contraceptive methods during the preceding birth intervals, breast feeding and some demographic variables such as age, marital status, education. Pregnancy outcome variables such as, live births, stillbirths, abortion and infant deaths. Slightly over seventy five per cent of the study subjects were aged 20- 29 years, 59% and 27% were para 2-3 and 4-5 respectively. In more than 81% of the subjects, the birth interval was less than three years with a mean birth interval of 22.1 months. Approximately two per cent used contraceptive when the birth interval was 12 months and less. Stillbirth and early neonatal deaths accounted for 3.2% and 6.9% respectively. Based on the findings, we underscore the importance of birth spacing using the available family planning methods to promote safe motherhood and achieve better child survival.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 126417.Ouvrage
Ilinigumugabo A.; Walla G.; Azombo M.
Causes et conséquences des grossesses chez les adolescentes au Cameroun
1996 - s.l.: Centre d'Etudes de la Famille Africaine, Association Camerounaise pour le Bien-être Familial, 98 p.
Mots clés : adolescence; adolescent; grossesse adolescente; grossesse; risque; sexualité premaritale; connaissance, attitude; pratique; CAP; contraception; méthode contraceptive; facteur socio-économique; jeune; adolescent; âge; population; facteur démographique; famille; santé de la reproduction; fécondité; sexualité; comportement; planning familial; facteur économique
Pays / Régions : Cameroun; Afrique Centrale; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : In 1993, the Center for African Family Studies and the Cameroon Association for Family Well-Being interviewed 1302 adolescent mothers 12-19 years old and 436 mothers of adolescents who were pregnant before marriage. They also conducted 5 focus group discussions with single mothers 15-19 years old, boys younger than 24, mothers and fathers with daughters younger than 20 who had an out-of-wedlock pregnancy, and opinion leaders. The study was conducted in Mifi, Mezam, Meme, Mvila, Mfoundi, Worui, and Vina provinces of Cameroon. The aim was to identify the sociocultural and socioeconomic determinants of pregnancy among adolescents and the psychosocial, health, and economic consequences of adolescent pregnancy. 72% of subjects had already had multiple partners. Single mothers continued to have an active sex life after their out-of-wedlock pregnancy. 54% of subjects who had premarital sex received gifts after their first intercourse. Only 5.3% of non-pregnant subjects were using a contraceptive method at the time of the study. 20% of adolescents had signs of a sexually transmitted disease in the previous 12 months. The single mothers were often rejected by their parents, their school environment, and even by the community. They were poor and could not meet their needs. Family members often physically abused them as well as insulted them. Many adolescents underwent an illegal abortion. In conclusion, girls reach biological maturity without knowledge about female physiology or sexuality. Social pressures, especially by the family, which were once placed on adolescents to control their sexual behavior, have been greatly reduced due to youth attending schools far from home and to new behavior modes promoted by school peers and the mass media. Communication relationships between parents and their adolescent children are inappropriate in the new environment created by modernization (i.e., increased education levels, urbanization, and the mass media). Poverty leads girls to accept sexual relations in order to receive gifts.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 117210.Article de périodique
Benson J.; Nicholson L.A.; Gaffikin L.; Kinoti S.N.
Complications of unsafe abortion in Sub-Saharan Africa: a review
1996 - Health Policy and Planning, 11(2), p. 117-131
Mots clés : revue littérature; complication; demande; contraception d'urgence; contraception postcoitale; planning familial; méthodologie; facteur économique
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : The Commonwealth Regional Health Community Secretariat conducted a study in 1994 to document the magnitude of abortion complications in Commonwealth member countries. The literature review component of the study identified a significant public health problem in the region, as measured by a high proportion of incomplete abortion patients among all hospital gynecology admissions. Hemorrhage and sepsis were the most common complications of unsafe abortion seen at health facilities. Studies on the use of manual vacuum aspiration for treating abortion complications found shorter lengths of hospital stay and a reduced need for a repeat evacuation. Few articles focused exclusively upon the cost of treating abortion complications, but authors agreed that it consumes a disproportionate amount of hospital resources. Studies on the role of men in supporting a woman's decision to abort or use contraception were similarly lacking. Articles on contraceptive behavior and abortion reported that almost all patients experiencing abortion complications had not used an effective, or any, method of contraception before becoming pregnant, especially among the adolescent population, while there were almost no studies on post-abortion contraception. Almost all articles on the legal aspect of abortion recommended law reform to reflect a public health, rather than a criminal, orientation. Research needs are presented.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 114416.Article de périodique
Abdella A.
Demographic characteristics, socioeconomic profile and contraceptive behaviour in patients with abortion at Jimma Hospital, Ethiopia
1996 - East African Medical Journal, 73(10), p. 660-664.
Mots clés : enquête; demande; avortement; avortement spontané; fausse couche; contraception; méthode contraceptive; facteur socio-économique; étudiant; scolarisation; méthodologie; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; facteur économique
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : A descriptive prospective study of 285 abortion patients admitted to Ethiopia's Jimma Hospital during 1992-93 reveals significant demographic differences between women with induced abortion (n = 151) and those with spontaneous abortion (n = 134). This sample represented 44.1% of the total number of abortion patients admitted to this facility during the 12-month study period; the remainder refused to be interviewed. 81.7% of abortion patients were under 30 years old and 68.9% were married; however, the mean age of induced abortion patients (22.6 years) was significantly younger than that of spontaneous abortion patients (26.2 years), and women with induced abortion were significantly more likely to be single (48.6%) than those with spontaneous abortion (11.4%). Induced abortion patients also were significantly more likely to be nulliparous, students, and determined to use contraception in the future than their counterparts in the spontaneous abortion group. Overall, 234 (82%) of respondents stated their pregnancy was unwanted; 62% of women with unwanted pregnancies had used a contraceptive method at some point in the past 12 months, primarily the pill (66.9%) and abstinence (29.7%). There were 50 pregnancies among the 97 pill users. The most frequently cited reasons for nonuse of contraception were health-related concerns (33.9%), failure to anticipate sexual intercourse (39.9%), and a negative attitude toward or lack of knowledge about contraception (32.2%).
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 121281.Article de périodique
Magnani R.; N Rutenberg; McCann H.
Detecting Induced abortions from reports of pregnancy terminations in DHS calendar data
1996 - Studies in Family Planning, 27(1), p. 36-43Résumé : The World Health Organization (WHO) classification scheme for pregnancy terminations was modified to evaluate the accuracy of pregnancy terminations as spontaneous or induced abortion in Demographic and Health Survey (DHS) calendar data. The decision algorithm considered length of gestation at time of termination, whether contraception was used during the period before termination and, if so, reason for discontinuation, whether the pregnancy was wanted or unwanted, and age, parity, and marital status at the time of the pregnancy termination. 1993 DHS calendar data on 1539 pregnancy terminations from Turkey were applied to the classification method. The algorithm classified 1413 (92%) of the terminations. It classified 71.8% (1015) as probably induced compared to 63% as reported by survey respondents. The algorithm classified 28.2% (398) as probably spontaneous compared to 37% as reported by survey respondents. The ratio of test positive to true positive (i.e., sensitivity of the method) was 92.5%, showing that the algorithm does a good job at identifying true cases of induced abortions. On the other hand, the ratio of test negatives to true negatives (i.e., specificity of the method) was only 65%, suggesting that the algorithm yields a relatively large number of false positives. When the investigators considered the effects of errors caused by misreporting of classification on the efficacy of the proposed scheme, both sensitivity and specificity increased (assuming 10% error, 92.7% and 67.3%; 25% error, 92.9% and 71.4%; and 50% error, 93.3% and 79.1%, respectively).
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 111830.Article de périodique
Bugalho A.; Faundes A.; Jamisse L.; Usta M.B.; Maria E.; Bique C.
Evaluation of the effectiveness of vaginal misoprostol to induce first trimester abortion
1996 - Contraception, 53(4), p. 243-246
Mots clés : méthodologie; médicament; Misoprostol; méthode; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Mozambique; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : Two doses, 200 and 400 mcg of misoprostol, administered vaginally every 12 hours, up to four times, were tested in 101 and 133 healthy women, respectively, for interruption of pregnancies with 35 through 77 days of amenorrhea. The proportion of women who aborted increased with longer duration of treatment and was significantly higher with 400 than with 200 mcg (66% vs. 46% at 48 hours). Significance was maintained after controlling by age, body weight, parity, previous abortion, and gestational age. Abortions were classified as incomplete or complete, according to the presence or not of embryonic tissue in the uterine cavity, diagnosed by vaginal sonography. Vacuum aspiration was carried out in all cases not classified as complete abortion 48 hours after the initiation of treatment, or earlier in case of persistent bleeding or the woman's request. The possibility of increasing effectiveness by using a higher dose, shorter intervals, or longer duration of treatment is discussed. (author's)
Source : Abstract from CONTRACEPTION, V53(4): 243-246, Bugalho A et al: "Evaluation of the effectiveness of vaginal misoprostol to induce first trimester abortion" © 1996 Elsevier Inc.Chapitre d'ouvrage
Verschuur C.
Femmes chefs de famille, exclusion et santé
1996 - Femmes du Sud, chefs de famille, p. p. 271-300. Paris (FR): Karthala
Mots clés : éducationRésumé : Une part considérable des problèmes de santé des femmes chefs de famille est due à l'exclusion qui se rattache à ce statut. Bien qu'elles soient le principal "gagne-pain", elles ne bénéficient généralement pas des droits habituels d'un "chef de famille". Discriminées, surexploitées, pauvres parmi les pauvres, ces femmes connaissent des conditions de vie telles qu'elles affectent gravement leur état de santé, avec la détérioration qui s'ensuit sur la santé de leurs propres enfants. Ayant une faible formation, de maigres revenus, s'alimentant pauvrement, vivant dans un habitat où l'approvisionnement en eau potable et l'assainissement sont déficients, subissant les effets de la violence, les femmes chefs de famille souffrent de façon aiguë et amplifiée de l'accroissement des inégalités sociales. Leur moindre accès au système de santé, leur plus grande vulnérabilité et leurs besoins spécifiques (risques professionnels, surcharge de travail, santé mentale) forment une spirale de la détresse dans laquelle risquent d'être entraînés leurs enfants (Résumé d'auteur)
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Ilesanmi A.O.; Ighomererho E.O.
Fertility following ectopic pregnancy in an African population
1996 - Journal of Obstetrics and Gynaecology (Abingdon), 16(4), p. 281-284Résumé : Cases of ectopic pregnancy were analysed retrospectively at the University College Hospital, Ibadan, Nigeria from 1 January 1982 to 31 December 1992. The records of 151 patients who had at least 1 year of follow up were analysed for fertility after surgery for ectopic pregnancy. Fifty-nine patients (39.1 per cent) subsequently conceived. Forty-one (30.5 per cent) delivered at term, six (4.0 per cent) had abortions, seven (4.6 per cent) had repeat ectopic pregnancies, and 92 (60.9 per cent) remained secondarily infertile. Age less than 30 and absence of pelvic adhesions were associated with the best chance of fertility after ectopic gestation.
Source : source : Journal of Obstetrics and Gynaecology (Abingdon).Article de périodique
Bobzom D.N.; Chama C.M.
Gynaecological short communications
1996 - Journal of Obstetrics and Gynaecology (Abingdon), 16(5), p. 420-421
Source : source : Journal of Obstetrics and Gynaecology (Abingdon).Article de périodique
Hyjazi Y.; Diallo M.S.
Illegal or unsafe abortion in Guinea
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 50-52
Mots clés : adolescence; adolescent; complication; avortement; issue grossesse; mortalité maternelle; morbidité; femme; jeune; adolescent; âge; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; grossesse; santé de la reproduction; mortalité; maladie; complication
Pays / Régions : Guinée; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : In Guinea, it is estimated that 50% of maternal deaths resulted from complications arising from illegal abortions. Two hospital surveys were conducted in Deen and Donka, Conakry, respectively, to determine the prevalence of complications related to illegal or unsafe abortions and establish a proportion of adolescents within this high-risk group. The first study was prospective and covered the period of January-December 1992 and revealed 83 patients with complications resulting from illegal abortions, 31 (37.35%) of which were adolescent girls. Complications of induced abortion identified were infection (50%), hemorrhage (37%), and medicinal poisoning (12%). Out of the 83 patients, 10 died from complications. The second study was retrospective and covered the period 1990-93 and revealed 94 patients with complications associated with illegal abortion. Adolescent girls represented 31.9% of the cases, of which 80% were single and 40% were schoolgirls. The most frequent complications among adolescents were hemorrhage (50%) and infection (37%). The death rate was 20%. Proposed strategies to address this issue include: sex education, improving access of adolescents to family planning services, and establishing structures for the re-admission of girls who leave school due to pregnancy.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148344.Article de périodique
Lema V.M.; Rogo K.O.; Kamau R.K.
Induced abortion in Kenya: its determinants and associated factors
1996 - East African Medical Journal, 73(3), p. 164-168.
Mots clés : enquête; avortement; loi; demande; incidence; contraception d'urgence; contraception postcoitale; planning familial; mesure; méthodologie
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : As part of a larger survey of the epidemiology of unsafe abortion in Kenya, 1007 women admitted to 8 hospitals in 6 of Kenya's 8 provinces during October 1988-March 1989 for incomplete abortion or its complications were interviewed. 169 of these women (15.7%) were considered to have undergone induced abortion (115 women who admitted to interfering with their pregnancy and 57 women who had clear physical evidence of an attempt at pregnancy termination). The induced abortion rate ranged from 0.9% at the Malindi coastal district hospital to 36.4% at the only mission hospital (Chogoria) in the study. Although adolescents (10-19 years old) comprised 15.2% of the total study group, 29.6% of induced abortion patients were in this age group. 22.9% of the total study group, compared with 70.4% of the induced group, were unmarried. There was a steady increase in the proportion of women with induced abortion with increasing educational level, from 4.7% of those with no formal education to 26.3% among those with a college or university education. Induced abortion patients were significantly more likely than those in the broader group to be students (14.8%) or employed in the formal sector (13%). Contraceptive prevalence at the time of conception of the index pregnancy was 12.1% in the broader group and 23.1% in the induced abortion group. 37.8% of induced abortion patients, compared with 50.2% of non-induced women, reported to the hospital within 24 hours of initial symptoms of abortion. Finally, complications were more prevalent in the induced abortion group and included sepsis (34.3%), anemia (17.8%), genital injury (16.6%), and hemorrhage (12.4%). The one death in the induced abortion group was attributable to severe septicemia. The 15.7% induced abortion rate identified in this study is considered to be an underreport, as suggested by the finding that 38.6% of the total study group stated their pregnancy was unwanted.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 126531.Article de périodique
Rogo K.O.
Induced abortion in sub-saharan Africa
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 14-25
Mots clés : loi; soin; santé de la reproduction; avortement spontané; fausse couche; complication; grossesse non prévue; grossesse non désirée; grossesse adolescente; grossesse; politique; programme; mortalité maternelle; contraception d'urgence; contraception postcoitale; planning familial; santé; complication grossesse; maladie; complication; fécondité; population; facteur démographique; mortalité
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : Three important conferences held in Nairobi in 1985-1987 helped focus world attention on the problem of maternal mortality in the Third World. Maternal mortality as a parameter, reflects the quality of reproductive health which has been defined as "the ability of men and women to undertake sexual activity safely, whether or not pregnancy is; desired and, if it is; desired, for the woman to carry the pregnancy to term safely, deliver a healthy infant and be prepared to norture it". Nowhere else in the world is; this; ability less pronounced than in Africa. This; is evident in the wide differences in the life lime risk of dying in pregnancy between the African woman and her counterparts elsewhere (Table 1). Africa has a young, active population and a reproductive health profile characterised by high fertility, very low contraceptive prevalence and high prenatal and maternal mortality rates. Access to means of pregnancy prevention is limited and in nearly all countries, access to safe abortion is legally and logistically remote. This has led to a high prevalence of induced abortion under unsafe conditions, making this; and related complications a leading cause of maternal mortality in the continent. There is increasing recognition that maternal mortality, above all, reflects the social and economic conditions under which women live, and that humanity already has both the means and ability to prevent most of these deaths. But, available and affordable as these means are, the will and commitment to apply them
Source : Source :Ceped.Article de périodique
Johnston H.B.; Hill K.
Induced abortion in the developing world: Indirect estimates
1996 - International Family Planning Perspectives, 22(3), p. 108-115
Mots clés : enquête démographique et de santé; EDS; prévalence contraceptive; enquête; population; facteur démographique; planning familial; contraception; méthode contraceptiveRésumé : To enable donor agencies and family planning program managers to estimate future needs for contraceptive supplies in developing countries, data drawn from 106 Demographic and Health Surveys and Contraceptive Prevalence Surveys conducted in 35 Third World countries between 1974 and 1992 were reviewed. At least 2 surveys, conducted a minimum of 2 years apart, were used to permit calculation of changes in total and method-specific prevalence and annual rates of change. At the time of the most recent survey, 44% of respondents were using contraception and 35.5% were using a modern method; these rates were 31.6% and 24.0%, respectively, at the initial survey. Total contraceptive prevalence increased at an annual rate of 5%, while modern method use increased by 6%. Sterilization acceptance increased by 8% each year, while use of the pill, IUD, and condom registered annual increases under 2%. In 30 of the 33 countries for which data were available, the prevalence of sterilization grew at a substantially faster rate than that of other modern methods. Overall, these findings suggest a need for caution against unrealistically high forecasts of the demand for supply-based contraceptive methods. On the other hand, the population group eligible for contraception is increasing by 2-3% each year. It remains uncertain whether the increased availability of injectables and implants will result in greater overall contraceptive prevalence or simply substitute for pill, IUD, and condom use.
Source : Reproduced with the permission of The Alan Guttmacher Institute :http://www.agi-usa.org/pubs/journals/2210896.html.Chapitre d'ouvrage
Diouf P.
L'avortement à Pikine
1996 - In Y.d.N. Charbit, Salif (dir.) (Ed.) La population du Sénégal, p. 409-418. Sénégal: DPS - CERPAA
Pays / Régions : Sénégal
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Lukman H.Y.; Pogharian D.
Management of incomplete abortion with manual vacuum aspiration in comparison to sharp metallic curette in an Ethiopian setting
1996 - East African Medical Journal, 73(9), p. 598-603.
Mots clés : méthodologie; enquête; complication; aspiration; méthode; curetage; méthode; traitement; soin; facteur socio-économique; douleur; complication; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; intervention chirurgicale; méthode; intervention chirurgicale; facteur économique; maladie; complication
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : This institution-based case-control study emanated from the fact that manual vacuum aspiration (MVA) has been recently introduced in Ethiopia and Gandhi Memorial hospital is currently serving as the pioneering center. Abortion is an important medicolegal, social, political, and public health issue. The objectives of the study were to focus on abortion issues, to show that MVA is an alternative procedure applicable in the authors' setting, and to highlight some of the determinants that can influence the choice of procedure in the management of incomplete abortions of less than 12 weeks gestation. A total of 1896 patients who fulfilled the inclusion criteria underwent MVA or sharp metallic curettage during the study period. The main variables considered included sociodemographic characteristics, service providers, complications in relation to operators and method of surgery, duration of the surgery, patient pain evaluation, and uterine factors. MVA was found to be equally safe, effective, simple, and fast in the management of incomplete abortions. Integration of MVA in the medical training is recommended, as it is a measure which can greatly contribute towards the reduction of maternal morbidity and mortality especially in a developing country like the authors', where resources are scare and alternatives are quite limited. (author's modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 121284.Article de périodique
Anonymous
Maternal and child health family planning and abortion in Madagascar
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 53-55
Mots clés : grossesse non prévue; grossesse non désirée; loi; avortement; santé; santé enfant; planning familial; programme; issue grossesse; santé de la reproduction; fécondité; population; facteur démographique; contraception d'urgence; contraception postcoitale; grossesse
Pays / Régions : Madagascar; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : In Madagascar, the practice of abortion is illegal and a stiff penalty awaits offenders as, provided in the abortion laws. Studies revealed that despite the legal restrictions of abortion, a huge number of Malagasy women resort to abortion to get rid of an unwanted pregnancy. Most of these abortions are done in secret, with the help of traditional doctors or medical practitioners or paramedics, and still others try to manage abortion all by themselves. In 1998, there were 8934 recorded cases of induced abortion treated in public hospitals, with an abortion ratio of 58.3/1000 live births. Some women used abortion as a substitute for birth control methods. Factors like inaccessibility of family planning services and low level of knowledge about modern contraceptive methods contributed to the prevalence of abortion in Madagascar.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148345.Article de périodique
Hoestermann C.F.; Ogbaselassie G.; Wacker J.; Bastert G.
Maternal mortality in the main referral hospital in The Gambia, west Africa
1996 - Trop Med Int Health, 1(5), p. 710-717.
Mots clés : méthodologie; enquête; mortalité maternelle; décès; complication; risque; âge; étudiant; scolarisation; mortalité; population; facteur démographique; maladie; complication; complication grossesse; service de santé; programme; fécondité; taux fécondité; intervention chirurgicale; méthode; intervention chirurgicale; traitement; soin
Pays / Régions : Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A retrospective analysis of 78 maternal deaths was performed during 1991-92 to estimate maternal mortality at the maternity unit of the main tertiary level hospital in The Gambia. The non-abortion maternal mortality ratio (MMR) was 736/100,000 live births. Among the direct causes, hemorrhage caused most deaths (24%), followed by hypertensive disorders in pregnancy (21%). Sepsis was the main cause of death in 15%. Anaemia led among the indirect causes of death (8%) and was a cofactor in 41% of all deaths. Substandard care factors other than medical causes were determined involving health care facilities, staff, drugs and equipment, and patient-related factors. Well known risk factors of low age (19 years or younger) and nulliparity were highly represented in the maternal death group, and delivery by cesarean section occurred more than threefold compared to the overall cesarean section rate. Taking hemorrhage as an example, it is demonstrated that the way diagnoses are grouped significantly affects the statistical elaboration of maternal deaths. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 119278.Article de périodique
Alihonou E.; Goufodji S.; Capo Chichi V.
Morbidity and mortality related to induced abortions (a study conducted in hospitals of Cotonou, Benin in 1993)
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 58-65
Mots clés : méthodologie; enquête; mortalité maternelle; complication; facteur socio-économique; morbidité; femme; issue grossesse; étudiant; scolarisation; mortalité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; facteur économique; maladie; complication; grossesse; santé de la reproduction
Pays / Régions : Bénin; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : This study assesses socio-economic burdens of patients bearing complications arising from induced abortions in the hospitals of Cotonou, Benin, and outlying maternities. The 1-year prospective study took place in three centers. Patients included in the sample were stratified as: certain induced abortion (28.1%), probable induced abortion (19.5%), possible induced abortion (16.1%), spontaneous abortion (25.8%), and threatened abortion (8.7%). The higher number of cases were recruited among patients aged 20-34 years and were mostly married. The major reasons for hospitalization included hemorrhage and lumbar and pelvic pain. Genital hemorrhage was the most frequent complication encountered. Certain induced abortion was most often induced by the patient herself and was mainly due to the unwantedness of the pregnancy. Ignorance was the principal reason given for the non-use of contraception. Finally, the mortality rate was very high at 21/1000.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148347.Article de périodique
Huntington D.
OR experience in other countries: post-abortion care and FP counselling in Egypt
1996 - 91-94
Mots clés : soin post-abortum; counseling; planning familial; soin; aspiration; méthode; curetage; méthode; avortement; avortement spontané; fausse couche; infirmier; personnel de santé; santé de la reproduction; clinique; hôpital; service de santé; programme; santé; contraception d'urgence; contraception postcoitale; intervention chirurgicale; méthode; intervention chirurgicale; traitement; soin; complication grossesse; maladie; complication; éducation; personnel de santé
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : An examination of the results of an operations research (OR) study in two hospitals in Egypt reveals how the research methodology can be used to test an intervention. In this case, the intervention attempted to improve the care of patients hospitalized after an induced or spontaneous abortion. The intervention involved the introduction of mini-vacuum aspiration as an alternative to dilation and curettage, the use of local instead of general anesthesia, increasing the amount of information available to physicians, and training nurses in postabortal family planning (FP) counseling. Using World Health Organization guidelines, it was determined that about 60% of the patients had induced abortions. The intervention resulted in increased patient knowledge, improved infection control, increased use of vacuum aspiration, and increased use of local anesthesia. The physicians, however, did not communicate their increased knowledge with their patients. The intervention increased the range of reproductive health topics the patients were familiar with and led to an increase from 32 to 62% in intention to use FP. The results prompted several follow-up activities including working with medical schools to institutionalize the new intervention as the standard of care and devising a strategy for the importation of vacuum aspiration instruments.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 114015.Article de périodique
Emuveyan E.E.
Profile of abortion in Nigeria
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 8-13
Mots clés : revue littérature; avortement; législation; issue grossesse; contraception d'urgence; contraception postcoitale; planning familial; grossesse; santé de la reproduction
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This article offers insights on the profile of abortion in Nigeria. The first section of the paper analyzes the legal context of abortion in the country, which is governed by the provisions of the Criminal Penal Codes. Sections 228, 229, 230 and 297 of the Criminal Code and Sections 232 and 234 of the Penal Code define the specific offenses and stipulate the punishment for them. The second section examines the proposed legislation, the "Termination of Pregnancy Bill," which was modeled after the English Abortion Act of 1967. Despite the indications that the proposed reforms in the Bill were widely accepted, groups of religious leaders and conservative women's societies pitted themselves against it. The third section provides information on the dimension of the problem in Nigeria based on findings of the different studies on abortion conducted in the region. It is generally estimated that 3 million abortions take place annually in Africa; 700,000 of these abortions may occur in Nigeria. The final section presents a study that utilizes focus group discussions to explore the knowledge, attitudes, beliefs, motives, and behaviors of women towards reproductive health and abortion. In light of the findings presented, the paper outlines policy changes that are needed, advocacy activities to facilitate such changes and areas of further research.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148341.Article de périodique
Mbizvo M.T.
Reproductive and sexual health: A research and developmental challenge
1996 - Central African Journal of Medicine, 42(3), p. 80-85
Mots clés : VIHRésumé : There is a growing awareness of the burden and implications of reproductive ill health as contributed by unsafe motherhood (during pregnancy, childbirth, abortion), reproductive tract infection (RTIs) and cancer, sexually transmitted infections (STIs) including the human immunodeficiency virus (HIV), poorly regulated fertility, infertility, unwanted pregnancy and adolescent/teenage sexuality and pregnancy. Sexual health further entails a state of well-being in expression of sexuality, prevention of unwanted pregnancies, prevention of STIs and AIDS and freedom from sexual abuse and violence. Reproductive health is increasingly being recognized as one of the corner stones of health and a major determinant and indicator of human social development. It is central to general health as it reflects health in childhood and adolescence and sets the stage for health and life expectancy beyond the reproductive years. It is affected by other health aspects such as nutrition and environment, low birth weight, neonatal and perinatal mortality and morbidity. According to the WHO, reproductive health problems account for more than one third of the total burden of disease in women and more than 10pc of that in men. The challenges posed by the subordinate status of women, the exclusion of men in reproductive health programmes and the need for shaping adolescents' sexual knowledge and behaviour are viewed against today's poor reproductive and sexual health outcomes in the context of Africa. Education systems, employers and policy makers are challenged to provide adequate STI/HIV education and on-site (school, work, satellite, drop in) control services. Prevention interventions, disease and health trends and their outcome require systematic research in order to impact on policy. Reproductive health education should be universal, especially for adolescents, and its impact assessed against appropriate monitoring criteria such as reproductive morbidity, STI prevalence and abortion complications.
Source : source : Central African Journal of Medicine.Article de périodique
Mbizvo M.T.
Reproductive health in Zimbabwe: What are the challenges?
1996 - Zimbabwe Science News, 30(3), p. 71-74
Mots clés : santé de la reproduction
Pays / Régions : ZimbabweRésumé : Reproductive health is a state of physical, mental and social wellbeing that encompasses the prevention of morbidity and mortality arising from sexual contact, fertility regulation, abortion and pregnancy. Often, outcomes from poor reproductive health are manifested in the female, who has to suffer the consequences of excessive pregnancies and childbearing, often asymptomatic sexually transmitted infections (STI) and abortion. It is probable that the woman will suffer more serious consequences of STI in the long run, which could include pelvic inflammatory diseases (PID), pregnancies outside the uterus (ectopic pregnancy), chronic pelvic pain, cancer of the cervix and infertility. Both the 1994 Cairo meeting on population and development and the 1995 Beijing conference on women and children brought into focus, once again, the continued suffering of people, especially women and children in sub-Saharan Africa, from reproductive ill health. Little attention has been given to the role of men as targets and agents of improved reproductive health through their education and social mobilization. Adverse reproductive health outcomes are also reflected in the youth. In Zimbabwe and elsewhere, many adolescents become sexually active or pregnant before they are physically or emotionally mature with consequences for their reproductive health, to which AIDS/HIV is a recent addition. This paper argues for the wider introduction of reproductive health education intervention especially among the youth, with the aim of preventing the disease burden being experienced in Zimbabwe.
Source : source : Zimbabwe Science News.Article de périodique
Tadesse E.
Return of fertility after an IUD removal for planned pregnancy: A six year prospective study
1996 - East African Medical Journal, 73(3), p. 169-171Résumé : This study was conducted in a series of 810 women who opted to use copper T-200 as a reliable form of contraception. The objective of the study was to determine the return of fertility after the removal of the IUD and to identify IUD related complications in an African setting. The study focused on 810 women who had requested for the removal of their IUDs at the time of planned pregnancy. Out of 810 cases only 780 cases were analysed. In eight(1%) of the cases, the IUD was removed because of full blown pelvic infection and 22(2.8%) of the cases lost to follow up. The mean age was, 29 years. Twenty five (3.2%) of the cases were nulligravidae, 729 (91.5%) multipara, and 45 (3.3%) grand multipara. Six hundred and fifty (83.3%) were married. All the clients who entered the study could afford to go to private clinic for family planning services. Conception occurred in 160 (20.5%) in the first two cycles, 201 (25.8%) between the third and fifth cycle, 250(32.%) between the sixth and eight cycles and 60 (7.7%) between the ninth and twelfth cycle. The remaining 109 (13.9%) of the cases failed to conceive within one year after the removal of IUCD. They have unprotected sexual intercourse for a. period of one year. Finally, the pregnancy out come showed the following results: spontaneous abortion 57 (7.3%), preterm birth 25(3.2%), term delivery 589 (75.5%) and no pregnancy after the removal of the IUD in 109 (13.9%), respectively.
Source : Source : East african medical journal.Article de périodique
Anonymous
Scaling-up improved postabortion care in Egypt: introduction to university and Ministry of Health and Population hospitals
1996
Mots clés : enquête; avortement; échec; avortement spontané; fausse couche; traitement; soin; counseling; personnel de santé; hôpital; hospitalisation; connaissance, attitude; pratique; CAP; soin; étudiant; scolarisation; méthodologie; service de santé; programme; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; clinique; hôpital; service de santé; santé; éducation
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : This study expanded on a 1994 pilot study to institutionalize improved postabortion medical services and counseling in 10 hospitals in Egypt. Pre/post-tests were used to measure the effect of the introduction of improved medical care and counseling procedures on providers' knowledge and practices and on selected patient outcomes. Data were gathered by interviews with 501 physicians, 574 nurses, and 1005 postabortion patients and by review of 1036 medical records. Ways to improve services were introduced in a 5-day training-of-trainers program. Post-test results showed that the percentage of patients treated for incomplete abortion by dilatation and curettage (DC) dropped from 98% to 40%, the use of local versus general anesthesia increased from 1% to 31%, 75% of physicians perceived lower complications with the use of manual vacuum aspiration (MVA), 61% found MVA easier to use than DC, and 56% found MVA more effective. The intervention dramatically increased physician knowledge about fertility resumption, improved the follow-up information provided to postabortal patients, and increased the number of women intending to use a family planning method from a third to a half. It is recommended that sustainable supplies of equipment for MVA be made available at an affordable price, that a protocol for use of MVA be included in medical school curricula, that the Ministry of Health and Population play an essential role in securing necessary drugs for pain and infection control, that logistic and administrative barriers for integrated care be removed, and that nurses be trained in postabortal care.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 128682.Article de périodique
Christianson M.A.; Christianson A.L.
South African geneticists' attitudes to the present Abortion and Sterilisation Act of 1975
1996 - South African Medical Journal, 86(5), p. 534-536
Mots clés : méthodologie; enquête; loi; législation; médecin; personnel de santé; counseling; stérilisation; échec de contraception; étudiant; scolarisation; attitude; psychologie; facteur psychologique; comportement; contraception d'urgence; contraception postcoitale; planning familial; personnel de santé; soin; santé; clinique; hôpital; service de santé; programme; stérilisation; contraception; contraception; méthode contraceptive
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In January 1994, 23 (92%) of all 25 clinical geneticists and genetic counselors in South Africa completed a confidential questionnaire designed to ascertain their attitudes toward the Abortion and Sterilisation Act of 1975. The questionnaire had 14 core questions previously asked of gynecologists (1990) and psychiatrists (1992). It focused on Section 3(1)(c) of the Act, which addresses termination of pregnancy (TOP) for genetic reasons. No one thought that the Act should be more restrictive, and only 17.4% found it acceptable in its present form. 91.3% and 73.9% supported TOP on request for girls aged less than 14 and 16 years, respectively. 60.9% and 56.5% supported TOP on request for failed female and male sterilization, respectively. Support was lower for failure of contraception (39.1-43.5%). 39.1% and 17.4% supported TOP on request before and after 12 weeks gestation, respectively. 82.6% considered a 5% or higher risk a serious risk. 60.9% believed that the pregnant woman herself should make the decision as to what constitutes a serious risk. 47.8% thought that she should decide what constitutes a physical or mental defect that would cause irreparable serious handicap. Only 21.8% thought that the Act allowed the patient to decide what constitutes a serious risk and what constitutes a physical or mental defect. 95.7% agreed with the currently accepted ethos of nondirective genetic counseling. Yet the Act does not allow nondirective counseling in the opinion of 43.5% of respondents. 56.5% thought that Section 3(1)(c) of the Act was acceptable in its present form. 69.7% believed that no need existed for future legislation to restrict TOP on genetic grounds. These findings tend to concur with those of gynecologists and psychiatrists who were surveyed earlier about this Act. They stress the need for review of the Act.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 117068.Rapport
World Health Organisation
Studying unsafe abortion : a practical guide
1996 - World Health Organisation, Geneva, 96
Mots clés : méthodologie
Source : source : WHO.Article de périodique
Kamau J.N.
Synthesis of special studies on: legal and policy barriers affecting sexual and reproductive health services in: Burkina Faso, Senegal, Swaziland, Zambia. 2nd ed
1996
Mots clés : santé de la reproduction; planning familial; programme planning familial; législation; loi; genre; santé; politique; programme; avortement; contraception d'urgence; contraception postcoitale; femme; facteur socio-économique; facteur économique
Pays / Régions : Burkina Faso; Sénégal; Zambie; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique Francophone; Afrique Australe; Afrique Anglophone; Afrique de l'EstRésumé : This booklet summarizes the results of the studies undertaken in 4 African countries to examine the existing legal and policy barriers to reproductive health. The studies were conducted in Burkina Faso, Senegal, Swaziland, and Zambia. The studies address issues relating to the conflict between written statutory law and customary law, emphasizing the effects of dual legal systems. The studies reveal that under such systems, concerns and rights of women cannot be recognized. In addition, the studies explore issues relating to information and access to family planning services. Whereas, the rights to information on family planning methods is now internationally recognized as a fundamental human right, the studies reveal that access to information in many countries such as Swaziland can be affected by legislation that criminalizes the advertising and display of family planning methods. In addition, existing framework for population activities and programs does not reflect the needs and concerns of the people and a great majority of women in the reproductive age group are not receiving contraceptive services. Meanwhile, abortion remained illegal in these countries except in Zambia where the liberal law allows for abortion, but only upon the recommendation of 3 doctors. The studies conclude with concrete suggestions and recommendations, which call on governments to review and amend existing legislation to address reproductive health concerns of women. Proposed areas of intervention aimed to remove the legal and social barriers, which hinder access to family planning and hinder the status of women, and address abortion issues.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148384.Article de périodique
Nyong'o D.; Oodit G.
Tackling unsafe abortion in Mauritius
1996 - Planned Parenthood Challenges, 1), p. 35-37
Mots clés : religion; loi; planning familial; législation; femme; contraception d'urgence; contraception postcoitale; attitude; psychologie; facteur psychologique; comportement; facteur socio-économique; facteur économique
Pays / Régions : Maurice; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Afrique FrancophoneRésumé : Despite a contraceptive prevalence rate of 75% Mauritius has a high incidence of unsafe abortions because of unprotected intercourse experienced by many young women in a rapidly industrializing environment. The Mauritius Family Planning Association (MFPA) tackled the issue of unsafe abortion in 1993. Abortion is illegal in the country, and the Catholic Church also strongly opposes modern family planning methods, thus the use of withdrawal and/or calendar methods have been increasing. The MFPA organized an advocacy symposium in 1993 on unsafe abortion with the result of revealing the pressure the Church was exerting relative to abortion and contraceptives. The advocacy campaign of the MFPA consists of having abortion legalized on health grounds and improving family planning services, especially for young unmarried women and men. The full support of the media was secured on the abortion issue: articles appeared, meetings were attended by the press, and public relations support was also received from them. The MFPA worked closely with parliamentarians. A motion was tabled in 1994 in the National Assembly which called for legalization of abortion on health grounds, but the Church squelched its debate. In March 1994 MFPA hosted the IPPF African Regional Conference on Unsafe Abortion in Mauritius with the participation of over 100 representatives from 20 countries, and subsequently a second motion was tabled without parliamentary debate. The deliberations were covered by the media and the Ministry of Women's Rights recognized abortion as an urgent issue as outlined in a white paper prepared for the Fourth World Conference on Women held in Beijing in 1995. The campaign changed the policy climate favorably making the public more conscious of unsafe abortion. The Ministry of Health decided to collect more data and the newly elected government seems to be more open about this issue.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 113814.Article de périodique
Likwa R.N.; Whittaker M.
The characteristics of women presenting for abortion and complications of illegal abortions at the University Teaching Hospital, Lusaka, Zambia: an explorative study
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 42-49
Mots clés : méthodologie; enquête; demande; complication; avortement; facteur socio-économique; issue grossesse; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; facteur économique; grossesse; santé de la reproduction
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This paper describes the findings of a prospective study of women presenting with a request for termination of pregnancy with the diagnosis of abortion complications at the University Teaching Hospital in Lusaka, Zambia. The study identifies some socio-economic characteristics of these women, comparing those obtaining legal abortions with those obtaining illegal abortions. Women utilizing the legal abortion facilities tend to be older (20-29 years), married or single, multiparous, educated to secondary level or above, and received the termination under the medical indication of "risk of injury to physical or mental health of the pregnant woman". On the other hand, women who resorted to illegal abortion tended to be young (15-19 years), unmarried, nulliparous, and schoolgirls who indicated their reason for termination as "being a student". The majority of women had never used contraceptives and 5.5% of the women who had requested a legal termination had an unwanted pregnancy resulting from discontinuation of use of a contraceptive. About 11% of the illegal abortion seekers had had at least 1 illegal abortion previously. The majority of women in both groups had had a termination within the gestational age range of 8-12 weeks. Traditional health providers and/or traditional methods were the major source and method of illegal abortions. The paper makes recommendations for service deliverers, researchers, and policy-makers in Zambia to improve the present situation.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148343.Article de périodique
Renne E.P.
The pregnancy that doesn't stay: the practice and perception of abortion by Ekiti Yoruba women
1996 - Social Science and Medicine, 42(4), p. 483-494
Mots clés : anthropologie; méthode; rural; résidence; attitude; perception; avortement; culture; médicament; contraception d'urgence; contraception postcoitale; planning familial; population; facteur démographique; psychologie; facteur psychologique; comportement
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : It is argued that the rural Ekiti Yoruba of northern Ondo State in Nigeria hold cultural beliefs about prenatal development, infertility, and conception that help to explain the continued reliance on abortion as a means of birth control. Other factors affecting abortion use are economic conditions and access. Ekiti local herbalists and pharmacies provide abortifacients to women who want to take a "medicine that spoils a pregnancy." The distinction between contraception and abortifacients is blurred. This paper presents a description of the practices and perceptions of abortion among rural Ekiti Yoruba women. The research during June 1991-March 1992 in a rural village northeast of Ado-Ekiti involved a census and interviews among 70 women aged 15-39 years and among 66 men aged 20-44 years. Interviews were also conducted among diviners, herbalists, and clinic owners. A demographic survey was conducted among 300 women. The cultural ideal is for women to bear children every 2-3 years and to control childbearing through sexual abstinence. Contraception and abortion are expected to be hidden from others. Various reports indicated that abortion was a common practice. Results from the larger survey indicate that 15.6% of women aborted a pregnancy at least once in their lives. In-depth interviews revealed that most women knew of other women who had abortions. The women most likely to use abortion were unmarried school girls and married women with outside partners. The five case histories among women who had abortions reveal that parents of school girls generally are involved in treatment and payment for their daughters abortions. All women desired an early abortion. The reasons for early abortion were concerns for maternal health, fetal development, and the emergence of a "real child" after the fourth month of pregnancy. Dilation and curettage are viewed as having the same potential for "cleaning the womb" as infertility medicines. The Minister of Health in 1991 proposed legalization of abortion. Some of the arguments for and against abortion are discussed.
Source : Source : Social Science Medicine.Congrès
Konate M.K.; Kolars C.; Diallo F.S.
The social consequences of induced abortion in Bamako, Mali
1996 - Presented at the Annual Meeting of the Population Association of America, New Orleans, Louisiana, 8 p.
Mots clés : méthodologie; enquête; loi; demande; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Mali; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Although induced abortion is officially illegal in Mali except to save the life of the mother, abortion practitioners and patients are rarely prosecuted. Preliminary quantitative findings are presented of a Center for applied Research on Population and Development (CERPOD) study conducted in Bamako during 1995-96 on the social consequences of induced abortion. The quantitative component of the study explored the sociodemographic characteristics and the contraceptive and abortion histories of a random sample of reproductive health clinic clients in the nation's capital. First, a pre-test was conducted involving 999 randomly selected female patients from four family planning and prenatal clinics and one hospital-based gynecological care unit in the city. That pre-test was then followed by a full-scale survey of more than 3000 randomly-selected, ever-sexually-active female patients of three of the four clinics and the hospital unit upon their exit from a medical consultation. One in seven women in the study population had attempted an abortion and 14% were suffering from abortion-related complications at the time of the interview. Induced abortion was most frequently reported by women attending gynecological care consultations. Comprehensive findings are presented.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 116047.Article de périodique
Anonymous
The use of induced abortion in Mauritius: alternative to fertility regulation or emergency procedure?
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 72-75
Mots clés : méthodologie; grossesse non prévue; grossesse non désirée; loi; avortement; issue grossesse; contraception; méthode contraceptive; contraception d'urgence; contraception postcoitale; santé de la reproduction; fécondité; population; facteur démographique; planning familial; grossesse
Pays / Régions : Maurice; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Afrique FrancophoneRésumé : Abortion is illegal in Mauritius, but despite these legal restrictions abortions are very much part of the reproductive health picture in Mauritius. To examine why Mauritius women are risking their lives, their health, and their reproductive futures by engaging in illegally induced abortions, the Mauritius Family Planning Association conducted a study of 475 women treated in 3 hospitals with abortion complications during the period of January-April 1992. Both qualitative and quantitative data collection approaches were employed. The primary reason for abortion was unwanted pregnancy, which was perceived as a threat to the individual and the family and often resulted from the improper use of contraceptive methods such as withdrawal and natural family planning or from the lack of use of any family planning method at all. About 92.9% of the subjects used a crude and/or self-induced method to abort, which explains why these women suffer complications. The picture that emerges from these data shows a group of women committed to the improvement of their ability to control fertility in the future. Recommendations for future actions are outlined.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148349.Article de périodique
Rutter T.
Unsafe abortion
1996 - Africa Health, 18(3), p. 23-24
Mots clés : complication; mortalité maternelle; morbidité; santé de la reproduction; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique; maladie; complication; santé
Pays / Régions : AfriqueRésumé : Annually, worldwide, there are approximately 150 million births and 50 million abortions. In Africa, more than 90% of abortions are unsafe, the highest rate in the world. One in 200 women in Africa who have abortions die as a result of the procedure. This mortality rate is the highest in the world, accounting for more than 30% of total maternal mortality in some countries. The latest UN report, published in February 1996, found Africa to claim 20% of the world's births and 40% of global maternal mortality. The best way to reduce abortion-related maternal mortality is to prevent unwanted pregnancy. The second-best defense against the mortality of unsafe abortion is the provision of safe abortion services. The appropriate management of the complications of unsafe abortion can also reduce maternal mortality and morbidity.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 113578.Article de périodique
Kampatibe N.; Mensah E.
Unsafe abortion and family planning in TogoAvortement a risques et planification familiale au Togo
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 77-78
Mots clés : loi; complication; planning familial; soin post-abortum; législation; avortement; contraception d'urgence; contraception postcoitale; complication grossesse; maladie; complication; programme planning familial
Pays / Régions : Togo; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : The population growth rate in Togo is 3.1%, the contraceptive prevalence rate is 8%, and the birth rate is 45%. The rate of illegal abortion cannot be determined because of its clandestine nature. Togo is theoretically governed by a 1920 French law, but in reality, the law has fallen into disuse. Likewise, the Family Code promulgated in 1981 does not address the issue of abortion. The 1984 Girl Protection Law penalizes persons having sexual relations with a female student or apprentice. These laws are rarely enforced. Healers or poorly qualified health workers clandestinely perform induced abortion. Pregnant women even perform the abortion themselves. In Togo, the law against abortion is taken lightly. There is no official institution that advises women on contraceptive methods. A family planning program does operate in about 100 health centers, however.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 114242.Article de périodique
Mosaase M.L.; Tlebere P.
Unsafe abortion and post abortion family planning in Africa: the case of Lesotho
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 26-28
Mots clés : enquête; mortalité maternelle; complication; planning familial; service de santé; morbidité; femme; risque; étudiant; scolarisation; méthodologie; mortalité; population; facteur démographique; avortement; contraception d'urgence; contraception postcoitale; soin de santé primaire; soin; santé; maladie; complication
Pays / Régions : Lesotho; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Available data suggest that more than half of the gynecological admissions in Lesotho are due to abortion--incomplete, complete, inevitable, or induced. Accurate figures of abortions induced outside the hospital setting remain unknown as patients are usually unwilling to reveal such information. Nevertheless, it is estimated that about one-quarter of maternal deaths are secondary to complications of abortion; namely, severe hemorrhage, postabortal sepsis, poisoning from ingestion of abortifacients, and perforation. Contributing factors to unsafe abortion include: educational needs, failed contraception, stigma attached to childbearing out of wedlock, lack of support from spouse/family, disparity in contraceptive usage, religion, and lack of family planning services for adolescents. The government has shown its commitment to improvement of the quality of life of women by launching the Lesotho Safe Motherhood Initiative. The following strategies are suggested in an effort to reduce the incidence of unsafe abortions in Lesotho: 1) expansion of maternal health and family planning services; 2) health education; 3) provision of family planning services for adolescents; 4) empowerment of women; 5) promotion of research in health and related issues; 6) compulsory education; 7) health statutes, laws, policies, and law reform; and 8) establishment of a gynecological emergency theater.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148342.Article de périodique
Anonymous
Unsafe abortion in Gambia
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 56-57
Mots clés : adolescence; adolescent; avortement; loi; offre; praticien; prestataire; demande; jeune; adolescent; âge; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé
Pays / Régions : Gambie; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Gambia has no abortion law of its own, but it is governed by the provisions of the England Application Act 1953 (as amended in 1965) and the provisions of the Koran for cases that appear in the Muslim courts. Teenagers account for more than 50% of induced abortions in the country. Most of the cases of induced abortions are conducted outside the institutions approved to perform the procedure because charges for abortion, particularly in the government and private medical facilities are high and affordable. Hence, cases of induced abortion in government hospitals and clinics show a decline, as back street abortions appear to be the only choice for many women who need the services due to prohibitive cost of abortions in hospitals and clinics.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148346.Article de périodique
Anonymous
Unsafe illegal abortion in Ethiopia
1996 - African Journal of Fertility, Sexuality and Reproductive Health, 1(1), p. 68-71
Mots clés : grossesse non prévue; grossesse non désirée; adolescence; adolescent; mortalité maternelle; morbidité; femme; loi; avortement; complication; planning familial; issue grossesse; programme; soin; santé de la reproduction; fécondité; population; facteur démographique; jeune; adolescent; âge; mortalité; maladie; complication; contraception d'urgence; contraception postcoitale; grossesse; santé
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : Despite all efforts to promote modern family planning services, Ethiopia demonstrates a particularly alarming increase in the incidence of unwanted pregnancies and incomplete and unsafe/septic abortions, particularly among adolescents. It is estimated that unsafe/illegal abortions accounted 54% of all direct obstetric deaths. Studies have shown that unsafe illegal abortion is rampant among single women, teenagers, students, and factory workers. This trend clearly demonstrates that the country still lags behind in delivering family planning services due to infrastructural and policy constraints that impede effective service delivery. Given the political commitment and support of the government, focus on improving the status of women through education, employment, and health becomes the most serious undertaking. The outcome of such action will be the key solution to the empowerment of women and in reducing the high abortion rates. In addition, improving availability and accessibility of family planning services in working areas and institutions and ensuring availability of trained manpower to render essential services is necessary. The role of nongovernmental organizations, private sectors, women's associations, and the community is vital in promoting successful programs in family planning.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 148348.Article de périodique
Bugalho A.; Bique C.; Pereira C.; Granja A.C.; Bergstrom S.
Uterine evacuation by vaginal misoprostol after second trimester pregnancy interruption
1996 - Acta Obstetricia Et Gynecologica Scandinavica, 75(3), p. 270-273
Mots clés : méthodologie; médicament; méthode; Misoprostol; méthode; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : The purpose of this investigation was to study the capacity of vaginal misoprostol in combination with methylergometrine to achieve complete evacuation of the uterus without ensuing surgical evacuation of the uterine cavity. The authors performed this trial on 228 women seeking pregnancy interruption. Vaginal misoprostol was given in a dosage of 800 mcg in early second trimester. All women received concomitant treatment with peroral methylergometrine from the moment of misoprostol application every 8 hours until uterine evacuation. Follow-up was continued until the first menstruation after interruption. Complete uterine evacuation was achieved in 173/228 cases (76%, group 1). The remaining 55 women (group 2) underwent manual evacuation of placental remnants trapped in the cervix. In seven of these women a conventional curettage was carried out due either to ultrasound evidence of placental remnants or due to uterine bleeding. The interval between misoprostol application and fetal expulsion averaged 14.9 hours (s.d. 9.6) in group 1 and 21.0 hours (s.d. 14.5) in group 2 (p = 0.006). Misoprostol, in combination with methylergometrine, is a remarkably efficient drug in achieving uterine evacuation also in the absence of surgical evacuation of the uterine cavity. The present study provides justification for a more expectant attitude after vaginal misoprostol treatment for pregnancy interruption. The avoidance of close to 80% of otherwise conventional curettages would seem to represent a major advantage, particularly in settings where manpower and material resources are scarce. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 114282.Article de périodique
Okonofua F.E.; Odimegwu C.; Aina B.; Daru P.H.; Johnson A.
Women's experiences of unwanted pregnancy and induced abortion in Nigeria. Summary report
1996
Mots clés : méthodologie; prévalence; communauté; grossesse non prévue; grossesse non désirée; avortement; mesure; résidence; population; facteur géographique; santé de la reproduction; fécondité; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This population-based study was conducted to determine the prevalence and pattern of abortion use among women in two communities of Nigeria. Using a structured questionnaire, 1516 randomly selected women aged 15-45 years were interviewed by trained female interviewers in Ile-Ife and Jos Local Government Areas in southwest and northern areas of Nigeria. Results show a high frequency of reports of unwanted pregnancy and induced abortion among the women. In both communities, unwanted pregnancy was most commonly reported to be due to "bad timing"; the next most common reason given was that the women were still in school at the time they became pregnant. There are < 10% of women supporting the full liberalization of abortion. However, more than half of the women supported liberalization of abortion when a woman is seriously ill or carrying an abnormal baby, or when an unwanted pregnancy occurs as a result of rape. These results suggest that detailed information can be obtained on abortion in areas with restrictive laws if a sensitive approach to interviewing is adopted.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 161188.Article de périodique
Johnson B.R.; Horga M.; Andronache L.
Women's perspective on abortion in Romania
1996 - Social Science and Medicine, 42(4), p. 512-530
Mots clés : contraception; méthode contraceptive; planning familial; femme
Pays / Régions : RoumanieRésumé : Romanian women have commonly used abortion (both legal and clandestine) to prevent unwanted births. We introduce this paper with a brief summary of the recent history of abortion in Romania, then we combine quantitative data from a previous report ([1] Johnson et al., Lancet 341, 875, 1993) of the research with women's own words about the following issues: their decisions to have an abortion, the impact of abortion restrictions under the Ceauescu government, and their needs and desires for improved reproductive health services. We also present gynaecologists' views of abortion restrictions and needs for improved family-planning services to make a compelling case for the need for safe, legal, comprehensive abortion care in Romania and elsewhere.
Source : Source : Social Science Medicine.
1994Article de périodique
Stenersen H.; Wien K.
Adolescence, family planning and reproductive health
1995 - Tidsskrift for den Norske Laegeforening, 115(24), p. 3052-3053
Mots clés : adolescence; adolescent; planning familial; santé de la reproductionArticle de périodique
Goddard C.
Adolescent sexuality in Nigeria. The facts
1995
Mots clés : méthodologie; adolescence; adolescent; sexualité; sexualité premaritale; risque; contraception; méthode contraceptive; grossesse non prévue; grossesse non désirée; grossesse adolescente; grossesse; avortement; mariage; état matrimonial; information; VIH; maladie sexuellement transmissible; MST; IST; excision; demande; jeune; adolescent; âge; population; facteur démographique; psychologie; facteur psychologique; comportement; planning familial; santé de la reproduction; fécondité; contraception d'urgence; contraception postcoitale; nuptialité; état matrimonial; mariage; maladie; maladie; complication; IST; MST; infection; complication; facteur économique
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : 21 million Nigerians--22% of Nigeria's population of 96 million--are aged 10-19 years. Early sexual activity, marriage, and childbearing limit the educational and employment opportunities of these young people and expose them to dangerous health risks, including sexually transmitted diseases (STDs) and HIV. Young women experience first sexual intercourse at the median age of 16 years, and 80% of young women have experienced sexual intercourse by age 20. First intercourse comes earlier for rural women than it does for urban women. One survey of more than 5500 urban youth aged 12-24 found that 44% of females and 37% of males had experienced sexual intercourse. About 60% of youth surveyed were unaware that pregnancy can result from first intercourse. Nationwide, 5.9% of women aged 15-19 use contraception, although only less than 1% use condoms, foaming tablets, or IUDs. A study of male secondary students in Ile-Ife found 80% to be sexually active in the past year, and more than half reported multiple partners, but only 8% of these latter students reported having used condoms. Early unprotected sexual intercourse leads to many unintended pregnancies, unsafe abortions, and abortion-related complications. Abortion is illegal in Nigeria except to save a woman's life. Nigeria's adolescents lack information on STDs/HIV. Finally, the practice of female genital mutilation, vesico-vaginal fistula, early female marriage, and low educational status among women are other factors which complicate adolescent development in the country.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 133408.Article de périodique
Huntington D.; Nawar L.; Abdel Hady D.
An exploratory study of the psycho-social stress associated with abortions in Egypt. Final report. Sub-Contract No. C.3821
1995
Mots clés : méthodologie; complication; avortement spontané; psychologie; facteur psychologique; comportement; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : Induced abortion is permitted in Egypt when health risks endanger the life of the pregnant woman. 31 postabortion patients in El Galaa and El Menia University hospitals were interviewed, and focus group discussions were held with family planning clients in Cairo and Menia and noncontracepting women in the attempt to determine their concerns with regard to improving the counseling they receive. The data were collected during May-June 1995. Approximately half of the women interviewed experienced spontaneous miscarriage, while the rest induced abortion. Those who had spontaneously aborted a pregnancy reported an almost complete ignorance of the reasons for the miscarriage, causing them considerable anxiety about their ability to carry any future pregnancies to full term. The most salient issue for all types of postabortion patients was, however, their physical survival of an extremely painful experience and the shock of physical hemorrhaging. All of the patients were very concerned about their ability to recover from the abortion and they were bothered by the need to return to their daily routines. Their main concern was physical recuperation through rest and improved diet, but they were convinced that their husbands would be of little help in that regard. The husband and his family may even blame the woman for losing the baby. Women in the study generally saw no need to use a contraceptive method immediately postabortion, for many believed that menstruation probably does not occur for some time after an abortion. The authors recommend informing husbands about their wives' health, their return to fertility, and the need for a recuperation period. Moreover, postabortion patients require explanations about the return to fertility using popular concepts, some of which are indicated in the body of the report. Clinical protocols for pain control medication should be reexamined and the more frequent use of post-operative analgesics needs to be encouraged, when appropriate.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 110482.Article de périodique
Lassey A.T.
Complications of induced abortions and their preventions in Ghana
1995 - East African Medical Journal, 72(12), p. 774-777.
Mots clés : loi; avortement; effets secondaires; mortalité; complication; adolescence; adolescent; adulte; âge; contraception; méthode contraceptive; femme; épidémiologie; hôpital; hospitalisation; homme; grossesse; grossesse extra-utérine; prévalence; enquête
Pays / Régions : GhanaRésumé : Although Ghana's abortion law was liberalized 10 years ago, widespread cultural and religious disapproval of pregnancy termination persists and unhygienic, clandestine induced abortions are common. The records were reviewed of 212 women admitted to Korle-Bu Hospital in a 12-month period during 1993-94 with complications from induced abortion. 85 (40.5%) of these women were 15-20 years of age and none had used a modern contraceptive method in the 3 months preceding the pregnancy. Over 95% of women were self-referred to the hospital at a time interval ranging from the day of the procedure to 2 months after abortion. 58% of pregnancy terminations were performed outside legally designated health institutions and 30% were self-induced. Sepsis was present in 15.7% of cases from health institutions and 21.5% of those from unregistered premises or self-induced. Of the 5 deaths in this series (2.4% mortality rate), 2 involved self-induction. The case fatality rate for septic abortion was 7.5%. 85.7% of the patients required surgical intervention and 17.6% received blood transfusions. Over 10% of the women required laparotomy, generally for ectopic pregnancies mistaken for intrauterine pregnancies. 56% of the women spent 1-3 days in the hospital, while 24.3% required 7 or more days. Postabortal counseling and contraception had been provided in only 13.5% of non-self-induced abortions. Recommended are educational campaigns on pregnancy prevention, easy access to reliable contraception, training and continuing education on abortion and its complications for physicians, regular inspection and monitoring of registered clinics to ensure hygienic conditions, and public debate on the amended abortion law.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 121495.Article de périodique
Tu P.; Smith H.L.
Determination of induced abortion and their policy implications in four countries in North China
1995 - Studies in Family Planning, 26(5), p. 278-286Résumé : China's 1-child policy was introduced in 1979, giving incentives to couples who pledged to have only 1 child, and penalizing couples who bore three or more births. Second births were discouraged, but not penalized. However, in 1981 and 1982, in urban and then rural areas, policy changed to forbid second births except under extraordinary circumstances. By 1983, mandatory IUD insertions, abortions, and sterilizations were reported. Policy, however, eased in 1984 and further during the late 1980s. China's 1-child policy will have a major long-term impact upon the country's population and economic development. Panel data are presented from the 1989, 1991, and 1993 waves of the China Health and Nutrition Survey conducted in 167 communities in 8 provinces. Local policy, including policy strength, incentives, and disincentives, is described separately for urban and rural areas. The data indicate that no single 1-child policy exists. Rather, policy varied considerably from place to place and within individual communities during 1989-93.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 109934.Article de périodique
Klugman B.; Stevens M.; Arends K.
Developing women's health policy in South Africa from the grassroots
1995 - Reproductive Health Matters, 3(6), p. 122-131Résumé : The Women's Health Conference in South Africa in December 1994 aimed to identify women's health needs and translate them into policy proposals. The process was inclusive and bottom up and cut across barriers of race, class and ideology. Prior to the conference, policy groups developed draftproposals on major areas of women's health, while provincial networking got input from the grassroots. The conference gave women space to talk about their experiences and finalise the proposals. Work on implementation has now begun; some proposals are being used by a number of provinces and by the Ministries of Health and Welfare and the Reconstruction and Development Programme's Gender Commission. In light of the proposal on abortion, the current abortion law is being reviewed by a Parliamentary Select Committee.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Chapitre d'ouvrage
Ndamobissi R.
Fécondité et stérilité
1995 - Enquête démographique et de santé, République Centrafricaine 1994-95, p. p. 39-56. Calverton, Maryland (US): Macro International Inc.Direction des Statistiques Démographiques et Sociales
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Petchesky R.P.
From population control to reproductive rights: feminist fault lines
1995 - Reproductive Health Matters, 3(6), p. 52-161
Mots clés : droitRésumé : The Programme of Action of the International Conference on Population and Development 1994 enshrines an almost-feminist vision of reproductive rights and gender equality in place of the old population control discourse but retains a mainstream model of development under which that vision cannot possibly be realised. This `fault line' is highly dangerous for feminists, because it configures a gap between the politics of the body, sexuality and reproduction and the politics of social development and global economic transformation. An analysis that makes explicit the concrete links between macro-economic policies and the materialisation of reproductive and sexual rights for all the world's women is needed.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Anonymous
Improving the counseling and medical care of post abortion patients in Egypt. Final report
1995
Mots clés : aspiration; méthode; counseling; soin post-abortum; éducation; avortement; contraception d'urgence; contraception postcoitale; planning familial; clinique; hôpital; service de santé; programme; santé de la reproduction; programme planning familial; service de santé
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : The impact of an intervention that upgraded physicians' clinical and interpersonal communication skills on postabortion outcome was assessed in a pilot project carried out in the obstetrics-gynecology wards of two Egyptian hospitals. The five-day training program for senior staff included demonstrations of manual vacuum aspiration instruments, guidelines for the management of incomplete abortion, treatment of abortion-related complications, pain management, and family planning counseling. The emphasis of the training was on holistic patient care. The evaluation was based on 552 observations of abortions, 550 patient interviews, 154 physician interviews, and 66 nurse interviews as well as review of the records of 1141 postabortion patients. 47% of abortions were classified as induced prior to hospital admission and 48% were spontaneous abortions. In the pre-intervention period, dilatation and curettage under general anesthesia was standard procedure; after the training, manual vacuum aspiration was used in over 90% of procedures and only 52% of patients received general anesthesia, resulting in a shorter hospital stay. Other changes noted in the post-intervention period included improved infection control, fewer reports of pain, dramatic increases in the provision of counseling on postoperative problems and family planning issues, and a rise from 37% in the pre-intervention period to 62% in the percentage of abortion patients who intended to initiate contraceptive use. Based on the effectiveness of this project, a larger scale program is planned to introduce manual vacuum aspiration and minimal pain control medication to other areas of Egypt and to provide medical staff with family planning counseling skills.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 105735.Article de périodique
Huntington D.; Hassan E.O.; Attallah N.; Toubia N.; Naguib M.; Nawar L.
Improving the medical care and counseling of postabortion patients in Egypt
1995 - Studies in Family Planning, 26(6), p. 350-362.
Mots clés : programme; soin post-abortum; counseling; traitement; soin; soin; personnel de santé; médecin; personnel de santé; planning familial; santé de la reproduction; clinique; hôpital; service de santé; santé; éducation
Pays / Régions : Egypte; Afrique du Nord; Afrique; Pays arabes; Pays MéditerranéensRésumé : This report analyzes the results of an operations research project carried out at two sites in Egypt to improve the medical care and counseling of postabortion patients. Preintervention and postintervention surveys and observations were conducted. After the introduction of vacuum aspiration under local anesthesia, the number of cases treated with dilatation and curettage under general anesthesia dropped from an average of 169 per month to 16. The majority of the remaining cases (an average of 119 per month) were treated with vacuum aspiration. Both providers' and women's knowledge about postabortion complications improved. Family planning information provided to postabortion patients increased as a result of the project's training program. The proportion of patients intending to use a contraceptive method increased by 30 percentage points due to the improved counseling. Future programs linking family planning and postabortion medical services should be prepared to improve the medical care of existing emergency health services and to add counseling services. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 110818.Article de périodique
Anate M.; O.Awoyemi; Oyawoye O.
Induced abortion in Illorin, Nigeria
1995 - International Journal of Gynecology Obstetrics, 49(197-198Résumé : no abstract
Source : Source : International Journal of Gynecology Obstetrics.Article de périodique
Fantahun M.; Chala F.; Loha M.
Knowledge, attitude and practice of family planning among senior high school students in north Gonder
1995 - Ethiopian Medical Journal, 33(1), p. 21-29
Mots clés : enquête; école; scolarisation; étudiant; scolarisation; connaissance; grossesse adolescente; grossesse; avortement; contraception; méthode contraceptive; méthodologie; éducation; communication; santé de la reproduction; fécondité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : Sexual experience, knowledge, attitude, and practice of contraception was studied among 991 senior high school students 15-17 years old in 3 secondary schools in north Gonder, Ethiopia, in May 1993 using an anonymous questionnaire. 304 (30.7%) students reported that they had experienced sexual intercourse. 14 (4.6%) of these students had started sex life at 14 years of age. 42 (13.8%) students had sex only with a spouse, 150 (49.3%) with a boyfriend or girlfriend, and 59 (19.4%) with a prostitute. 44 (14.5%) had sex with more than one of these. Out of 83 sexually active female students 25 (30.1%) reported having been pregnant. Seven students had been pregnant twice. Only 4 students admitted to having had an abortion. 750 (75.7%) students claimed that they knew at least 1 method of modern contraception. 750 (75.5%) students knew at least 1 contraceptive method, with the pill being best known (60.7%) followed by the condom (50.8%). 731 (73.8%) students recounted that the condom protects against sexually transmitted diseases. 365 (37.8%) students cited schools as the source of contraceptive information; 265 (27.5%) cited books; 185 (19.2%) cited friends; 122 (12.7%) cited the mass media; and 27 (2.8%) mentioned sexual partners. 533 (53.8%) students wanted to have sex with only 1 partner; 48 (3.8%) preferred many partners; and 13 (1.3%) did not want sexual intercourse at all. The minimum number of children wanted was 2, and 82 (8.3%) wanted to have 7 to 14 children. 51 (5.1%) of the respondents had used a modern contraceptive: 31 had used the condom and 20 had used the pill. 929 (93.7%) had never used any contraception. Only 16.6% of those with sexual experience had used contraceptives. 15 students got contraceptives from health institutions, 23 from drug vendors, 7 from shops, and 5 from friends. Knowledge of pills and positive attitude to contraception were significantly associated with modern contraceptive use. The most common reason for not using modern contraceptive methods among sexually active respondents was little or no knowledge of contraceptives (70 or 27.7%) followed by no access to contraceptives (54 or 21.3%) and harmful effects of contraceptives (50 or 19.8%). It is recommended that family life education should be conducted in high schools along with counseling and clinical family planning services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 105509.Article de périodique
Livitsanos E.
Knowledge, attitudes, and practices of sexually transmitted diseases and maternal health in Uganda: a literature review
1995
Mots clés : revue littérature; connaissance, attitude; pratique; CAP; attitude; risque; maladie sexuellement transmissible; MST; IST; santé; soin prénatal; naissance; allaitement; avortement; culture; préservatif; contraception; psychologie; facteur psychologique; comportement; IST; MST; infection; complication; maladie; complication; service de santé; soin de santé primaire; soin; issue grossesse; grossesse; santé de la reproduction; programme planning familial; planning familial; contraception d'urgence; contraception postcoitale; méthodes barrières; contraception; contraception; méthode contraceptive
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A literature review provides a basis for the Delivery of Improved Services (DISH) Project for designing focus groups and in-depth interviews on the knowledge, attitudes, and practices of Ugandans related to non-AIDS sexually transmitted diseases (STDs) and maternal health. STDs pose a great threat to health in some areas of Uganda and to adolescents (early age of first sexual intercourse and gap between knowledge and practice). STDs are most common in youth, especially males. Genital ulcer diseases (GUDs) (e.g., syphilis) are prevalent in Uganda. Many women have vaginal discharge. They tend to consider vaginal discharge to be normal and not an indication of an STD. People with a history of an STD or current GUD are more likely to be HIV infected than those with neither. Most rural and adolescent Ugandans do not know that STDs facilitate HIV transmission. Younger adolescents know almost nothing about STDs. Even though most Ugandans know the most common STDs and how they are transmitted, they know little about how to detect them, their treatment, and their possible effects on health. Many people know that condoms can prevent STDs; yet few men and women use them. Many Ugandans have adopted risk reduction behavior after learning about STDs. Uganda has among the world's highest maternal mortality rates. Most pregnant women attend at least one prenatal visit, especially late in pregnancy. Women understand the importance of prenatal care, but many are ill at ease with the atmosphere of the health facilities. Few women know what constitutes a high risk pregnancy. Midwives provide most prenatal care in urban Uganda. As many as 66% of women do not deliver with the assistance of a trained attendant but deliver at home with relatives, untrained traditional birth attendants, or alone. Determinants of who will attend the delivery are the woman's education, residence, and age. Multiparous women are less likely to deliver with a trained provider. Most women breast feed for 14 months on average. Abortion is illegal in Uganda; yet induced abortion contributes to as many as 20% of all maternal deaths.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 115596.Rapport
Koffi N.G.
La planification familiale dans le Centre Nord, sous préfectures de Katiola, Niakaramandougou et Tafire.décembre 1995.
1995 - Études et recherches, ENSEA, Abidjan, 131
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Anonymous
Legal and political barriers affecting sexual and reproductive health services : International Planned Parenthood Federation Africa Region, 1995.
1995 - Reproductive Health Matters, 3(6), p. 177
Mots clés : politique; programme
Pays / Régions : Afrique
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Anonymous
Legislation on abortion in Africa
1995 - African Population Newsletter, 67), p. 5-6
Mots clés : législation; loi; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : AfriqueRésumé : Abortion is subject to legislation in 51 countries in Africa. In 22, it is permitted only to save the mother's life. In 33, the procedure can be performed to save the mother's life and/or physical health. These reasons join other justifications in 17 countries. 15 countries allow abortion to preserve the mother's mental health, 11 in cases of incest, 10 in cases of fetal impairment, 3 for economic or social reasons, and 1 on request. The least restrictive legislation is found in Seychelles, Uganda, Zambia, and Zimbabwe in East Africa; Cameroon in Central Africa; Algeria and Tunisia in North Africa; Botswana, Namibia, the Republic of South Africa, and Swaziland in Southern Africa; and Cape Verde, Gambia, Ghana, Guinea, Liberia, Sierra Leone in West Africa.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 107446.Article de périodique
Fortney J.A.; Kiragu K.
Maternal mortality and morbidity in Sub-Saharan Africa
1995
Mots clés : revue littérature; santé; mortalité maternelle; décès; risque; facteur socio-économique; planning familial; avortement; allaitement; mortalité; population; facteur démographique; facteur économique; contraception d'urgence; contraception postcoitale
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : This paper reviews maternal mortality and morbidity in Sub-Saharan Africa from the perspective of a lifespan approach, which assumes that the mortality and morbidity result from a culmination of factors that may even have predated the woman's birth. Such factors include her mother's lack of prenatal care and adequate nutrition; the woman's diet during her life; insult from various diseases, injuries, and accidents; poor access to health care; and socioeconomic discrimination. Chapter 1 describes the lifespan approach in detail. Chapter 2 looks at the magnitude of pregnancy-related mortality and considers quantification difficulties, mortality estimates, pregnancy-related deaths and lifetime risk of dying, and morbidity estimates and trends. Chapter 3 considers maternal mortality as a public health problem that can be predicted, prevented, and cured. Chapter 4 describes the multiple causes of maternal death in terms of clinical causes, sociocultural factors, and health services. Chapter 5 discusses risk factors found in characteristics of the mother and the community and looks at the usefulness of risk scores. Chapter 6 covers the effect of family planning service provision on maternal health. Chapter 7 provides information on abortion, chapter 8 considers the role of breast feeding in compromising a mother's health, and chapter 9 concludes that the lifespan perspective allows an assessment of maternal health in light of the various factors that influence it.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 109464.Article de périodique
Kinoti S.N.; Gaffikin L.; Benson J.; Nicholson L.A.
Monograph on complications of unsafe abortion in Africa
1995
Mots clés : revue littérature; loi; complication; homme; soin post-abortum; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement; service de santé; programme; programme planning familial
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : In 1994, the Commonwealth Regional Health Community Secretariat for east, central and southern Africa conducted a study to substantiate the extent of abortion complications in the region during 1980-1994. In some countries, as many as 76% of hospital gynecology admissions are incomplete abortion patients. Thus, unsafe abortion is a significant public health problem. Hemorrhage and sepsis are the leading complications of abortion. There is limited information on the cost of treating abortion complications. Manual vacuum aspiration, an effective and safe method of emptying the uterus, reduces the cost for treating incomplete abortion cases by 66% when compared to sharp curettage. According to the limited information that exists in the literature on men's role, men do play a minor role in a woman's decision to end a pregnancy. They may provide financial support, however. Most women suffering from unsafe abortion complications either do not use effective contraception or use no contraception. There are many documents on the legal aspects of abortion. There are no documents on postabortion family planning services. Unsafe methods of induced abortion (e.g., traditional methods) cause serious injuries and death. Treatment of abortion complications are costly for health care systems. Concerns about side effects and lack of access to and information about family planning services are the major obstacles to contraceptive use. Abortion laws tend to be restrictive, which encourages illegal, unsafe abortions. The administrative requirements for legal abortion diminishes access to safe, legal abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 109283.Rapport
Mtimavalye L.A.; Pius O.; Ahmed Y.; Makata A.; Mirembe F.; Macwang'i M.
Monograph on Complications of Unsafe Abortion in Africa
1995 - CRHCS/CSA, JHPIEGO, Baltimore, 90 p. + annexesRapport
Diadhiou F.; Faye E.O.
Mortalité et morbidité liée aux avortements provoqués clandestins dans quatre sites de références dakarois au Sénégal.
1995 - UCAD/CGO/CHU Le Dantec, OMS/HRP, Dakar, 50Résumé : Cette étude porte sur l'analyse de la morbidité et de la mortalité liées aux APC au niveau de quatre structures sanitaires dakaroises. Elle se propose ainsi d'étudier les caractéristiques socio- économiques des femmes concernées par les avortements et le coût de la prise en charge thérapeutique des conséquences de ce phénomène. L'approche méthodologique développée par les auteurs leur a permis d'analyser les cas d'avortements recensés au niveau des quatre sites suivants du 1er mars 1993 au 28 février 1994 : le CGO du CHU le Dantec ; -le centre hospitalier municipal Abass Ndao ; -le centre de santé Dominique de Pikine ; -l'hôpital Principal de Dakar. Les limites de cette étude sont liées au fait qu'il s'agit d'une enquête hospitalière ne permettant donc pas l'analyse des avortements en milieu non hospitalier. En plus de la méthodologie utilisée, les auteurs ont défini les cinq formes d'avortements suivants : l'avortement provoqué certain, l'avortement provoqué probable, l'avortement provoqué possible, l"avortement spontané et l'avortement thérapeutique. Les résultats de l'analyse épidémiologique révèlent que les APC représentent au moins 19 % des avortements hospitalisés. Les chercheurs ont également analysé le profil des femmes exposées au risque de recourir à l'APC comparativement à celles concernées par les avortements spontanés. Il ressort de cette analyse comparative qu'il s'agit surtout de femmes jeunes (60 % des cas d'APC ont moins de 25 ans contre 30 % pour les cas d'avortements spontanés) et résidant en zone urbaine quelque soit le type d'avortement. Il apparaît également qu'il y a plus de femmes non mariées dans les cas d'APC que pour les avortements spontanés. De même, il y a plus de femmes instruites dans la première catégorie que dans la seconde. Cette analyse comparative des caractéristiques socio-économiques des femmes porte aussi sur leur profession, religion, nombre de grossesses et d'accouchements antérieurs, connaissance et pratique contraceptive. Cette étude est également consacrée à l'analyse des déterminants de l'avortement. Elle confirme ainsi la prédominance des déterminants sociaux de l' APC (la crainte des critiques des parents ou de l'entourage en cas de grossesse socialement non désirée). En ce qui concerne les aspects médicaux, les auteurs ont étudié les méthodes abortives utilisées, la qualification de l'agent avorteur et le lieu de la manoeuvre abortive. Ils se sont également intéressés aux motifs de consultation, à la répartition des avortements selon le terme gestationnel et à la mortalité maternelle par APC. Cette étude a mis en évidence les principales conséquences morbides de l'avortement suivantes: hémorragies, infections, traumatisme, infécondité et stérilité. Les auteurs ont également analysé les coûts financiers pour l'individu concerné et pour la structure sanitaire de la prise en charge thérapeutique des complications de l'APC et de l'avortement spontané. Enfin ils ont formulé un certain nombre de recommandations en matière d'études et recherche sur l'avortement au Sénégal.
Source : Source : Ceped.Article de périodique
Bradford H.
Olive Schreiner's hidden agony: fact, fiction and teenage abortion
1995 - Journal of Southern African Studies, 21(4), p. 623-641
Mots clés : adolescence; adolescent; avortement; attitude; psychologie; facteur psychologique; sexualité; femme; jeune; adolescent; âge; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; comportement; facteur socio-économique; facteur économique
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This article summarizes what is known about Victorian novelist Olive Schreiner's life and analyzes her work to support the hypothesis that as a teenager in 1872 Schreiner experienced an induced abortion, the information about which was deliberately destroyed. By applying a gender perspective to her fiction, the narratives reveal deeper and less socially acceptable meanings than those which are readily apparent. Thus, Schreiner simultaneously hid and revealed her abortion experience in her text. During the year in question, the 16-year-old Olive moved into the home of one of Dordrecht's most eligible bachelors to nurse his sister over typhoid. Passages from her highly autobiographical first novel reveal that she was probably seduced and became pregnant. The first extant piece of writing by this teenager was a story which can be read as the loss of an unborn child. Only through her fiction could this daughter of missionaries confess to her abortion. By applying a gender-specific narrative analysis to Schreiner's works, the code words used to express the unspeakable reveal themselves. In her life, Schreiner suffered from infertility which was corrected by an operation to correct an "extraordinary" retroversion of her womb. After the operation, Schreiner gave birth to a daughter who died the next day and then suffered three miscarriages. As a socialist author desperate for a baby, Schreiner placed herself in an unusual (for her) alignment with male opinion-makers who decried abortion and contraception.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 120080.Article de périodique
Godinez C.M.
Post-abortion family planning counseling training video for service providers in sub-Saharan Africa: a literature review
1995
Mots clés : mortalité maternelle; counseling; grossesse non prévue; grossesse non désirée; soin post-abortum; service de santé; personnel de santé; mortalité; population; facteur démographique; clinique; hôpital; service de santé; programme; santé de la reproduction; fécondité; soin; santé; éducation
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : In many developing countries, especially in sub-Saharan Africa, unsafe abortion has been documented as a major cause for maternal mortality. The prevention of maternal death is possible through the use of contraceptives that impede unwanted pregnancies. The enhancement of front-line service providers' skills in family planning counseling is essential for reaching this goal. To this effect, a training package that includes a video for service providers attending postabortion patients will be developed. Its objectives include: 1) increasing health care workers' and policy makers' awareness of the need for postabortion family planning services and counseling, and 2) providing information to health care workers about which family planning methods are appropriate for use during the postabortion period. This paper attempts to summarize a number of documents available in the literature on post abortion and family planning. It includes some documents that are not catalogued in the library systems such as trip reports, project reports, and other informal but valuable documents. Its purpose is to develop key ideas that will guide the program and help in the design of the formative research that will support the development of messages to be included in the training package.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 153626.Article de périodique
Feresu A.S.
Preliminary study in Zimbabwe: responses of traditional healers
1995 - 83-90
Mots clés : méthodologie; médecine traditionnelle; méthode; loi; attitude; planning familial; mariage; médecine; service de santé; soin; santé; avortement; contraception d'urgence; contraception postcoitale; psychologie; facteur psychologique; comportement; mariage; état matrimonial; nuptialité; état matrimonial; mariage
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : 18 traditional healers aged 31-74 years were surveyed in Zimbabwe with the goal of learning about the characteristics of traditional healers, assessing the use of traditional methods for family planning, and studying the views of traditional healers on issues such as modern family planning and abortion legislation. Most of the traditional healers surveyed are polygamists or advocate polygamy, and even females find it to be a good method of family planning. 89% reported problems with modern contraception and they talked about complications, such as children born disabled, and infertility, side effects, and failures. Abortion is illegal in Zimbabwe and available only under health-endangering conditions. Nonetheless, there are approximately 70,000 abortions carried out, most using traditional methods. Although these healers claimed to not provide abortion services, it is clear that women in search of abortions can secure them from traditional healers. The traditional health system is discussed, as well as the co-existence of traditional health care and biomedical science, and traditional family planning methods.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 111364.Article de périodique
Anate M.; Awoyemi O.; Oyawoye O.; Petu O.
Procured abortion in Ilorin, Nigeria
1995 - East African Medical Journal, 72(6), p. 386-390.
Mots clés : loi; prévention; adolescence; adolescent; adulte; âge; décès; femme; hôpital; hospitalisation; homme; mortalité maternelle; morbidité; épidémiologie; enquête; ville; résidence
Pays / Régions : NigeriaRésumé : A review of the cases of 144 women who presented to the University of Ilorin (Nigeria) Teaching Hospital between July 1992 and June 1994 with complications of illegal abortion underscores the health hazards associated with this procedure. There were 13 deaths (90.3/1000 procured abortions) in this series. 77 of the abortion patients were teenagers; another 35 were 20-24 years old. Teenagers were more likely than women in the older age groups to obtain their abortion in the second trimester of pregnancy. 85 women were single. Major occupations represented in the group included students (32 women), house girls/maids (23 women), and business/trading (20 women). The desire to remain in school or retain employment were the reasons most commonly cited for terminating the pregnancy. Sepsis occurred in 39 women, while 18 experienced hemorrhagic anemia. The causes of death included generalized septicemia (3 cases), sepsis with anemia (3 cases), sepsis with jaundice (2 cases), peritonitis with abscess (2 cases), uterine perforation with peritonitis (2 cases), and endotoxic shock (1 case). The maternal mortality and morbidity associated with illegal abortion in Nigeria suggest a need to make family planning services more available to adolescents and single women and to ensure that the scope of family life education is expanded.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 115785.Article de périodique
Katzenellenbogen J.M.; Abdool Karim S.S.; Fawcus S.
Putting the records straight -- a plea for improved abortion data editorial
1995 - South African Medical Journal, 85(3), p. 135-136
Mots clés : avortement; enquête; collecte; taux; loi; contraception d'urgence; contraception postcoitale; planning familial; méthodologie; analyse; mesure; information
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Estimates of the incidence of induced abortion and of its medical and economic sequelae are incomplete and conflicting in South Africa. The abortion ratio and estimates of morbidity and mortality related to abortion are indicators of women's health that allow public health officials to observe trends and changes in health status within subgroups of women. Three medical professionals find the current system of routine data collection on all types of abortion in South Africa to be inadequate. They call on medical practitioners to support the improvement of this system. The problems with the current system fall under three groups: inappropriate motives for data collection; problems with the forms used; and no standardization of definitions and no comprehensiveness in completing the forms. The motivation for data collection should be to inform public health policy and practice, not to monitor legal abortions and to restrict illegal abortions. Underreporting and misreporting are the norm with the present punitive data collection system. They plague the quality and completeness of abortion data. The data collection form only provides four categories for type of miscarriage which are neither mutually exclusive nor exhaustive. For example, an incomplete miscarriage can also be a septic miscarriage and some categories are excluded (e.g., missed abortion and blighted ovum). The form does not request data on potentially useful variables (e.g., date of last menstrual period, abortion method, cause of abortion, or health consequences). The form addresses three types of procedure: legal abortions; other removal of residues; and sterilization. It does not provide clear instructions on how to complete the form. Even though physicians perform the abortions, clinical record clerks sometimes reconstruct the data on the form. There should be a standardized procedure to prevent transcription errors. In conclusion, the three medical professionals call for a review of procedures, reasons, and forms for abortion data collection.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 107962.Article de périodique
Mbizvo M.T.; Kasule J.; Gupta V.; Rusakaniko S.; Gumbo J.; Kinoti S.N.; Mpanju Shumbusho W.; Sebina Z.; Mwateba R.; Padayachy J.
Reproductive biology knowledge, and behaviour of teenagers in East, Central and Southern Africa: The Zimbabwe case study
1995 - Central African Journal of Medicine, 41(11), p. 346-354
Mots clés : méthodologie; sexualité premaritale; adolescence; adolescent; santé de la reproduction; connaissance, attitude; pratique; CAP; risque; menstruation; sexualité; comportement; jeune; adolescent; âge; population; facteur démographique; santé
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A multicenter study of reproductive health knowledge and behavior followed by a health education intervention was undertaken among teenagers in selected countries of eastern, central, and southern Africa. Baseline findings are reported from the Zimbabwe component of the study. 1689 adolescents from rural, urban, coeducational, single sex, boarding, and day secondary schools in Zimbabwe participated in the study. 789 were aged 10-14 years, 872 were aged 15-19, 10 were older than 19, and 18 did not offer their age. 48.4% of participants were male. Correct knowledge on reproductive biology was measured by the meaning and interpretation of menstruation and wet dreams as indicated by responses to self-administered questionnaires. That knowledge varied by school from 68% to 86%, with a significant trend based upon the level of education at baseline. Menarche occurred at the reported mean age of 13.5 years, with first coitus occurring at the mean ages of 12 years for boys and 13.6 years for girls. 17% reported being sexually experienced and 33.2% were involved in relationships. 23% believed menstruation to be an illness. Peers, followed by magazines, were the main sources of information on reproductive biology. 56% of the respondents who reported being sexually experienced had unprotected sex. These findings point to the need to target adolescent students with information on reproductive biology and increased awareness on the risks of pregnancy, sexually transmitted diseases, and HIV.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 120189.Article de périodique
Brabin L.; Kemp J.; Obunge O.K.; Ikimalo J.; Dollimore N.; Odu N.N.; Hart C.A.; Briggs N.D.
Reproductive tract infections and abortion among adolescent girls in rural Nigeria
1995 - Lancet, 345(8945), p. 300-304
Mots clés : adolescence; adolescent; avortement; santé de la reproduction; rural; résidence; sexualité; maladie sexuellement transmissible; MST; IST; jeune; adolescent; âge; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; santé; comportement; IST; MST; infection; complication; maladie; complication
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Levels of reproductive health and induced abortion in Nigeria are analyzed using data for 868 women, of which 410 were aged 12-19, in a rural community in Rivers State. The data were collected in 1992. "43.6% of those [under age 17] and 80.1% aged 17-19 years were sexually active and at least 24.1% had undergone an induced abortion; only 5.3% had ever used a modern contraceptive....42.1% of sexually active adolescents had experienced either an abortion or a sexually transmitted disease." (EXCERPT)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - IND 8030435.Article de périodique
The Prevention of Maternal Mortality Network
Situation analyses of emergency obstetric care: Examples from eleven operations research projects in West Africa
1995 - Social Science Medicine, 40(5), p. 657-667
Mots clés : mortalité maternelleRésumé : Situation analyses were conducted by 11 multidisciplinary teams in the West African Prevention of Maternal Mortality (PMM) Network, with technical assistance from Columbia University's Center for Population and Family Health. Data on the functioning and use of facilities were used to identify resource needs and management problems at facilities providing emergency obstetric care in Ghana, Nigeria and Sierra Leone. The researchers looked at the number and distribution of facilities, trends in utilization patterns, time from admission to treatment at facilities, functioning of referral systems, availability of essential supplies, staffing patterns, and staff perceptions of services. Research methods included patient flow studies, inventories of drugs and supplies, and retrospective reviews of hospital records. Qualitative information was also collected through interviews with staff.This paper summarizes the principal findings of the situation analyses. Normal deliveries fell markedly where users' fees were initiated. However, the number of women with complications seen increased at several of these sites. The lack of drugs and supplies at the facilities had an adverse effect on utilization of non-emergency services and on women's survival chances. Users' fees and unavailability of supplies contributed to unacceptably long waiting times between admission and treatment at most sites. These long waiting times were also found to be associated with higher case fatality rates. Staff-to-patient ratios at the sites improved or remained stable, and do not appear to be associated with changes in quality of care. Strategies to address the problems identified include: the establishment of small revolving fund schemes to ensure the availability of supplies; the creation of 24-hr pharmacy services; the establishment of on-call rooms for staff; and the improvement of staff attitudes and morale through various types of training activities.These situation analyses were useful for assessing health system factors contributing to maternal deaths. The information on complicated cases and on hospital functioning provided a marked improvement over previous studies limited to data on deliveries and maternal deaths. Low-cost techniques such as the patient-flow studies and drug and supply inventories provided valuable information which was easily intelligible to program planners. These types of studies are recommended for use prior to the development of projects designed to reduce maternal deaths.
Source : Source : Social Science Medicine.Article de périodique
Sjostrand M.; Quist V.; Jacobson A.; Bergstrom S.; Rogo K.O.
Socio-economic client characteristics and consequences of abortion in Nairobi
1995 - East African Medical Journal, 72(5), p. 325-332.
Mots clés : loi; complication; épidémiologie; avortement spontané; fausse couche; adolescence; adolescent; adulte; âge; contraception; méthode contraceptive; femme; homme; connaissance; fécondité; grossesse; enquête; facteur socio-économique; ville; résidence
Pays / Régions : KenyaRésumé : A review of the cases of 281 women admitted to Kenyatta National Hospital (Nairobi, Kenya) in a four-week period in 1992 with a diagnosis of incomplete abortion revealed significant socioeconomic differences between illegal abortion patients and those with spontaneous abortion. The 91 women who denied induced abortion and had no signs of trauma were classified as spontaneous abortion patients (group 1). Group 3 included the 38 women who admitted to illegal abortion, while group 2 was composed of 152 women who denied illegal abortion yet had physical signs suggestive of infection and genital trauma. 17.4% of women in groups 2 and 3, compared to only 6.6% of those in group 1, lived at home with their parents; in addition, women in the former two groups were significantly more likely to be young, single, unemployed, to have more previous pregnancies, and to be informed about contraception. 90% of women with confirmed or suspected induced abortion expressed an interest in post-abortion contraception compared to only a third of women with spontaneous abortions. Women with spontaneous abortions were generally able to return home after uterine evacuation, while those in groups 2 and 3 suffered complications such as sepsis, peritonitis, and uterine wall perforation. There were four deaths among women in the latter groups (maternal mortality rate, 2.1%). The costs of treating the women in groups 2 and 3 were 300 times the costs for the care of group 1 patients. Interviews with 31 women who admitted illegal abortion indicated that the procedure was most often performed at an illegal clinic or at their home; 12 cases involved insertion of a rubber catheter into the vagina. The availability of safe, legal abortion in Kenya would save both lives and hospital costs.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 115786.Article de périodique
Huntington D.; Mensch B.S.; Miller V.
Survey questions for the measurement of induced abortion
1995
Mots clés : méthodologie; avortement; incidence; enquête; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; mesure
Pays / Régions : Cote d'Ivoire; Ghana; Egypte; Turquie; Mali; Bolovie; Sénégal; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique Francophone; Afrique Anglophone; Afrique du Nord; Pays arabes; Pays Méditerranéens; Moyen Orient; Asie; Amérique du Sud; Amérique; Amérique LatineRésumé : A number of surveys have been conducted using a new approach to questioning women about their abortion history. Data on the incidence of abortion is essential 1) to expose the severity of the public health problems caused by complications from illegal abortions, 2) to support legislative and programmatic change, 3) to determine the demand for contraception, and 4) to estimate fecundity and understand fertility dynamics. The use of an indirect approach may improve the accuracy of data collection about induced abortion. A study in Estonia used a filter question approach by asking women if any of their pregnancies did not result in a live birth and then asking them to describe the pregnancy outcome. This paper reports on the results of using a set of indirect questions that reminded the woman of having an unwanted pregnancy and then asked about the outcomes of the pregnancy. After achieving promising results in a field test in the Ivory Coast, the filter question and follow-up probe technique was used in clinic-based (in Ghana, Egypt, and Turkey), employment-based (in Bolivia), and population-based (in Mali) sample surveys. Based on results from these trials, the Demographic and Health Surveys used indirect questions in Indonesia and Senegal in 1993. In each case, the level of induced abortion appears to be underreported. In a 1994 Situation Analysis in Senegal, the indirect methodology was tested using a split-halves design with family planning (FP) and maternal/child health (MCH) clients. In each group (564 women asked direct questions and 557 asked indirect questions about abortion), 2% of the women admitted to having undergone abortion. However, reported levels of unwanted pregnancy are low in Senegal, and this topic may have been too sensitive to serve as an adequate filter question. A summary of results from studies on the use of the unwanted pregnancy filter question plus follow-up questions on abortion reveals that abortions are more commonly reported in FP/MCH clinic studies and in settings where abortion is legal. The mixed findings of the studies indicate that no single universally sensitive context exists for discussing abortion. More research is required to identify the best filter questions or the best way to establish a nonthreatening context.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 110661.Article de périodique
Solo J.; Muia E.; Rogo K.O.
Testing alternative approaches to providing integrated treatment of abortion complications and family planning in Kenya: findings from phase
1995
Mots clés : enquête; complication; traitement; soin; hôpital; hospitalisation; aspiration; méthode; programme planning familial; perception; étudiant; scolarisation; méthodologie; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé; programme; psychologie; facteur psychologique; comportement
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In order to address the need to determine how best to deliver postabortion care in different settings, the Africa Operations Research and Technical Assistance Project and the Ebert Program of the Population Council tested alternative approaches to providing integrated treatment of abortion complications and family planning in Kenya. Because induced abortion generally is not legal in Kenya, women often resort to illegal abortions that are usually done under unsafe conditions. Since this usually results in an incomplete abortion, many of the women then go to health facilities for emergency treatment. Phase I of this study obtained baseline information by administering a questionnaire to 25 hospitals on incomplete abortion caseloads. Eventually 18 hospitals were selected relying on 1993 records. Regarding the method of evacuation, manual vacuum aspiration (MVA) was performed in 11 of the 18 hospitals, while dilatation and curettage was available in all except one hospital. Regarding facility assessment, the sites of evacuation were the ward in 11 hospitals and the theater in 13. The sites of recovery were the ward in 14 hospitals, and bed occupancy ranged from 10% to 60%. The length of stay ranged from 10 to 78 hours with an average of 45 hours. The staff in the 18 hospitals consisted of on average of 1.4 specialists, 0.4 medical officer, and 3.9 nurses on duty to provide treatment for incomplete abortion. Provider perspectives also were assessed by interviewing 57 providers taking care of patients with abortion complications. Their perception of Kenya's abortion law was as follows: 33 felt that the current law was too restrictive, 16 said it was appropriate, 5 said it was too liberal, and 3 expressed no opinion. Abortion complications appeared in 21% of incomplete abortions and were mainly excessive bleeding, septicemia, and perforated uterus. The perspectives on postabortion family planning were assessed among 57 providers and 49 thought that incomplete abortion patients should be given family planning information while still in the hospital. 44 providers said that specified counseling should be provided in the ward, while 17 mentioned that methods should be made available in the ward. Regarding family planning services, monthly client loads ranged from 27 to 350 new clients. Of 75 providers, 71 indicated that the quality of services could be improved.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 112698.Article de périodique
Temisanren E.
Views of women in Yoruba culture and their impact on the abortion decision editorial
1995 - Women and Health, 22(3), p. 1-8
Mots clés : femme; genre; culture; décision; avortement; droit; facteur socio-économique; facteur économique; comportement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Male-dominated cultural values severely curtail the ability of Yoruban women to determine their reproductive health, including the right to choose abortion. Hegemonic in this culture is the view that a woman's role is to reproduce and to enable men to pursue a life of freedom. This subordinate status is reinforced by traditional songs that state, "My husband the owner of my head/My husband my lord/My husband the crown of my head." Abortion requires a freedom of thought and action that is not awarded to Yoruban women. In contemporary Nigerian society, the food supply is adequate to meet demand and social welfare spending does not yet constitute a significant drain on the national budget. Thus, the burden of an unwanted pregnancy is shouldered by the woman, not society. Needed is a women's liberation movement that redefines Yoruban women as social beings capable of rational decision making, especially in areas that affect their well-being.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 112250.
1993Article de périodique
Turkson R.B.
A brief overview of the legal situation regarding abortion in Sub-Saharan Africa
1994
Mots clés : loi; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : Abortion laws in the majority of sub-Saharan African countries can be classified as basic; they are based on statutes developed in England or France over a century ago and prohibit abortion under any circumstances. In Mauritius, for example, the Penal Code stipulates a maximum of 10 years of imprisonment for abortion seekers and providers and has remained unchanged with regard to abortion since the early 19th century; interestingly, the French Penal Code--the model for the Mauritian law--has been amended at least 5 times in the past 2 centuries. The Penal Law of Madagascar is also derived from French code, but was amended in 1929 to permit therapeutic abortion at the recommendation of 2 state doctors and a third physician selected by the woman. While either a blanket or highly restricted prohibition of abortion prevails in most Francophone countries south of the Sahara, English-speaking African countries tend to have what can be classified as more developed legislation that specifies certain conditions under which abortion is lawful. The R. vs. Bourne case of 1938, in which the English courts recognized the need to preserve a woman's mental as well as physical health, has served as the basis for reform. The Ghanaian Law, for example, was modified in 1985 to permit abortion in cases where the pregnancy would involve serious risk to the physical or mental health of the mother, was result of rape or incest, or there is a risk of serious congenital abnormalities or disease; unspecified, however, is a cut-off time beyond which abortion cannot be performed. In Zambia, the law contains a unique provision that permits abortion in cases where another child would represent a risk to the physical or mental health of existing children. Most likely is a scenario in which abortion laws in Africa South of the Sahara become liberalized incrementally, indication by indication. This process will be more difficult in the English- speaking countries, where there are religious and philosophical traditions for the view that life begins at conception.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094212.Article de périodique
Mahomed K.; Healy J.; Tandon S.
A comparison of manual vacuum aspiration (MVA) and sharp curettage in the management of incomplete abortion
1994 - International Journal of Gynecology and Obstetrics, 46(1), p. 27-32
Mots clés : enquête; aspiration; méthode; curetage; méthode; complication; mortalité maternelle; risque; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; intervention chirurgicale; méthode; intervention chirurgicale; traitement; soin; complication grossesse; maladie; complication; mortalité; population; facteur démographique; santé publique; santé
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This prospective longitudinal study was conducted from July 1990 to October 1991 in Harare Central and Parirenyatwa Hospitals in Harare, Zimbabwe, to determine whether manual vacuum aspiration (MVA) was as safe and effective as sharp curettage (SC) for treatment of incomplete abortion. Using a case-reporting form, researchers collected demographic and clinical data over a 3-month period in 1990 on 589 women treated with SC for incomplete abortion up to 12 weeks gestation. One year later, after the introduction of MVA, data were similarly collected on 834 women treated with MVA for incomplete abortion. In 1990, abortion accounted for 12% of maternal deaths and represented 67% of all gynecology emergency patients (n = 3470 women treated for incomplete abortion) at Harare Central Hospital, a tertiary care facility. Researchers found that there were higher rates of presenting sepsis in the SC group than in the MVA group (17% vs. 11%) (p < 0.001). Based on procedure-related complications at the time of treatment, MVA was found to be as safe as SC in treating incomplete abortion and more effective than SC in achieving complete uterine evacuation (0% incomplete evacuations vs. 0.7%) (p < 0.05). At the 2-week follow-up visit, the following results were found for MVA vs. SC patients, respectively: 0.3% vs. 2.7% were experiencing extreme pain; 1.6% vs. 2.5% were diagnosed with infection; and 0.7% vs. 4.5% were diagnosed with other complications. The authors concluded that given the safety and effectiveness of the MVA procedure and the potential for reducing health care costs and improving patient management with MVA, this technology should be considered by health care systems in developing countries for improving treatment of abortion complications.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101411.Article de périodique
Mirembe F.M.
A situational analysis of induced abortions in Uganda
1994
Mots clés : enquête; complication; demande; adolescence; adolescent; grossesse adolescente; grossesse; mortalité maternelle; offre contraception; avortement; contraception d'urgence; contraception postcoitale; planning familial; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; mortalité; contraception; méthode contraceptive
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Complications of illegal abortion account for about a third of the high maternal mortality rate (550/100,000 births) in Uganda and such cases represent a major drain on scarce hospital resources. Although statistics on the incidence of abortion in Uganda are not available, given its illegality, unwanted pregnancy and the resultant reliance on untrained clandestine abortionists pose a major threat to women's health. A 1992 survey conducted at Kampala's Mulago Hospital found that 68% of abortion patients were 15-19 years of age, 79% had never been married, and 57% had no prior pregnancy. 79% of these women were secondary school or university students. Given this profile, desire to continue one's education and fear of parental disapproval were the 2 most frequently cited reasons (50% and 26%, respectively) for seeking pregnancy termination. At Mulago Hospital, the major abortion-related complications treated are hemorrhage, sepsis, and genital tract trauma. In 1992 at that hospital, there were 28 deaths from these causes. Although there are indications that more physicians are now performing illegal abortions, meaning fewer complications and deaths, the need for safe, legal, and accessible abortion remains a priority. Hospital personnel need training in the management of the complications of illegal abortion and patients should receive postabortion family planning counseling. More surveys aimed at assessing the extent of the problem and its social context would be helpful to campaigns for abortion legalization. In the interim, attention must be given to improving Uganda's low contraceptive prevalence rate (6% in rural and 15% in urban areas) through community-based distribution and social marketing. Finally, the problem of adolescent pregnancy must be addressed through sex education in the schools and guidance to parents about how to talk to their children about sexual matters.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094216.Article de périodique
Benatar S.R.; Abels C.; Abratt R.; Anthony J.; Benatar D.; Brooks D.; Degenaar J.; Dent D.; de Villiers M.; Dommisse J.
Abortion -- some practical and ethical considerations editorial
1994 - South African Medical Journal, 84(8), p. 469-472
Mots clés : loi; religion; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique du Sud; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Abortions have been performed in many societies throughout the world for a long time. This continues, with the proportion of legal and illegal abortions varying from country to country. Available statistics suggest that the annual abortion rate per 1000 women aged 15-44 years ranges from less than 20 in many countries to 40-70 in others. Abortion has been a subject of only limited debate in South Africa where the 1975 Abortion and Sterilization Act clearly defines five circumstances in which abortion can be legally performed. Legal abortion may be performed in South Africa when a pregnancy poses a serious threat to the woman's life and health; when the pregnancy poses a serious threat of permanent damage to a woman's mental health; where a serious risk exists that the child will be seriously, irreparably handicapped; when the pregnancy is the result of alleged and reported rape or incest and such allegations are considered valid by two medical practitioners and are supported by a certificate from a magistrate that a complaint has been lodged; and where the pregnancy has resulted from unlawful carnal intercourse with a woman having a permanent mental handicap or defect. Many women, however, despite the legal status, will request and procure an abortion regardless of societal approval. This paper was prepared by a multidisciplinary bioethics group to provide a synoptic overview of the scope of public and professional debate about abortion with a view to broaden the reader's understanding of the extent to which unwanted pregnancies and their termination is a source of great distress to women and society as a whole, and to propose debate. The text focuses upon pregnancy and the health of the mother and fetus, with sections on abortion service and problems at Groote Schuur Hospital, positions on abortions in the Western world, current philosophical considerations, and the need to make abortion law in South Africa less restrictive.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 103138.Article de périodique
Mwanza G.
Abortion cases worrying
1994 - Z Magazine, 18
Mots clés : avortement; demande; sexualité; contraception d'urgence; contraception postcoitale; planning familial; facteur économique; éducation
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The writer believes that life begins the instant that an human sperm cell and ovule fuse. This life must be respected and preserved. Abortion is shameful, but tolerated when either the mother or would-be baby's life is at stake. As the number of abortions continue to increase, the controversy over a woman's right to abortion rages on. The author wonders whether questions about abortion will ever be resolved and considers some possible solutions with reference to Zambia. There are many early pregnancies among Zambian youths. A 1993 study found 207 abortions per year in the country among 15-19 year olds; this includes illegal, incomplete, and induced abortions. The Coordinator for the Young Women Christian Association in Lusaka thinks that inadequate sex education is one of the factors contributing to the ever-rising number of abortions today. Youths have sexual intercourse without understanding the possible consequences. Parents, community leaders, and school authorities should instead become more involved and teach children about sex to lessen the incidence of abortion. Specifically, parents should talk to their children about sex as they mature, teaching them about their biological reproductive features and functions. The author is convinced that once children and youths understand their bodies, it will be very easy for them to control their desires. Most male and female teens do, however, cite love and sexual desire as the primary motives for their first relationships. The writer also mentions how pregnant girls get expelled from school and that women experience mental and physical side effects from induced abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 099555.Article de périodique
Ojo O.A.; Phido F.; Hord C.E.; Benson J.; Wingate I.
An evaluation of provider acceptability and use of manual vacuum aspiration (MVA) in Nigeria
1994
Mots clés : évaluation; service de santé; complication; traitement; soin; aspiration; méthode; soin; santé; contraception d'urgence; contraception postcoitale; planning familial; éducation
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The purpose of this study was to determine provider acceptability and use of the manual vacuum aspiration (MVA) technique for treatment of incomplete abortion in Nigeria. MVA training programs, including on-the-job training and 1-week courses with didactic and clinical training for hospital staff, were conducted by International Projects Assistance Services (IPAS) in Ahmadu Bello University Teaching Hospital (ABUTH) in Zaria and Lagos University Teaching Hospital (LUTH) in Lagos between 1987 and 1990. Prior to expansion of the training programs in 1991, IPAS conducted an outcome-only evaluation. Of the 300 individuals who had participated in the MVA training courses, a convenience sample of 50 was chosen, and 41 (82%) of these individuals were found and interviewed. 26 had been trained at ABUTH, and 15 had been trained at LUTH; 37 (90%) had attended the 1-week training seminar, while 4 had received only clinical on-the-job training. The main outcome measures of this evaluation were: participants who changed their primary technique of uterine evacuation to MVA following training; participants who subsequently trained colleagues; and participants who would recommend MVA training to their colleagues. The results were as follows: 1) more than 75% reported treating incomplete abortion before and after the course, and, of these, 19% used MVA prior to the course, while 74% used MVA afterward; 2) use of sharp curettage decreased from 72 to 12% following the training; 3) all respondents said they would recommend MVA training to their colleagues, primarily because of lower complication rates and reduced resources needed to provide care; 4) 41 (56%) respondents trained colleagues when they returned to their institution, and 29% trained individuals from other institutions; 5) 95% knew the essential clinical facts about the MVA procedure, as determined by IPAS; 6) participants cited more training (noted by 24 participants), commodities (23), funds (18), and support from the Ministry of Health (15) as strategies for improving existing MVA services; 7) 59% thought MVA could be used safely for treatment of incomplete abortion at the primary level of the health care system; and 8) 33 (80%) recommended that both doctors and nurses be trained to provide MVA safely. Barriers to the widespread use of MVA that were noted by providers included lack of adequate authority among some who received training to perform MVA upon their return to their institution. The authors concluded that MVA programs have been successful in terms of both the continuity of MVA use and subsequent training conducted by course participants, and they recommended more widespread use of this technique to increase the quality and accessibility of services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101342.Article de périodique
Rogo K.O.
Analysis and documentation of research on adolescent sexuality and unsafe abortion in Kenya. A summary of studies by members of the Centre for the Study of Adolescence in the period 1988-1993
1994
Mots clés : adolescence; adolescent; avortement; demande; sexualité; enquête; personnel de santé; jeune; adolescent; âge; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; comportement; étudiant; scolarisation; méthodologie; soin; santé
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Chapter 1 of this analysis and presentation of research on adolescent sexuality and septic abortion in Kenya for the period 1988-93 provides general demographic background information and a discussion of how the current population policy is ambiguous in regard to adolescent fertility. Chapter 2 contains summaries of Kenyan studies on the following topics: 1) female adolescent health and sexuality; 2) the epidemiology of abortion; 3) case studies of induced abortions; 4) adolescent fertility and the abortion choice; 5) abortion as a traditional approach to unwanted pregnancy; 6) the abortion knowledge, attitude, and practice (KAP) of nurses; 7) the attitude toward abortion of medical personnel in Nairobi; and 8) a sexual and contraceptive practice KAP. Chapter 3 provides a discussion of related issues in the format of questions parents and policy-makers may ask, including 1) what is the level of sexual activity among Kenyan youth, 2) what is the prevalence of unwanted pregnancies and abortion, 3) who chooses abortion, 4) who performs abortions, 5) what is the incidence of abortion-related morbidity/mortality, 6) what kind of abortion law do Kenyans want and need, and 7) what can be done about adolescent sexuality and unsafe abortion. Also included in the report are the recommendations forwarded by participants at a seminar to disseminate these research findings. These recommendations call for policy changes, intensive health sector training, research, advocacy, and the dissemination of information.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 111484.Article de périodique
Ali Y.
Analysis of maternal deaths in Jima Hospital, southwestern Ethiopia
1994 - Ethiopian Medical Journal, 32(2), p. 125-129
Mots clés : mortalité maternelle; hôpital; hospitalisation; décès; loi; naissance; complication; mortalité; population; facteur démographique; service de santé; soin; santé; avortement; contraception d'urgence; contraception postcoitale; planning familial; issue grossesse; grossesse; santé de la reproduction; maladie; complication; statistique
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : The records of women who died in the obstetrics and gynecology wards of Jima Hospital in Ethiopia from October 28, 1991, to December 30, 1992, were studied to ascertain the causes of death, the circumstances of death, and preventable factors for each death based on clinical information that had been discussed at a regular meeting on maternal mortality. Postmortem examinations were not done. The pertinent clinical data were collected on a separate form. During the study period, there were 841 deliveries and 573 abortions in Jima Hospital, with 22 maternal deaths, yielding a maternal mortality rate of 26 per 1000 live births. The causes of death were illegally induced abortion (9), obstructed labor with ruptured uterus (6), postpartum hemorrhage (PPH) (3), and puerperal sepsis (1). Thus, direct obstetric causes were responsible for 19 (86%) of the deaths. The nonobstetric causes were 1 each for intestinal obstruction, pneumonia, and cerebral malaria. Abortion alone contributed 9 of the 22 (41%) of the deaths. Of the 573 women with abortions, 9 died (10.5 per 1000 abortions), and most of these had been admitted with hemorrhage or septic shock subsequent to illegal abortion. Among the 841 cases, there were 24 cases of ruptured uterus (2.8%), of whom 6 died. Rupture was spontaneous in 21 (87%). All multiparous women were from rural areas. Three maternal deaths were a result of PPH (13.6%), 2 of them from retained placenta following home delivery, and the 3rd in Jima Hospital from cervical laceration that extended to the lower uterine segment. The patient died one hour after delivery. Only 2 patients attended prenatal care among the 13 maternal deaths not caused by abortion. Seven of the 22 deaths occurred in the 31-35 year age group, while 6 of the deaths were in adolescents who had had illegal abortion. 12 deaths (54.5%) were in women whose parity ranged from 1 to 4. Five deaths (22.7%) were in grand multiparous women. 11 (50%) of the deaths occurred within 24 hours, and another 6 (27%) in the second 24 hours in the hospital, suggesting that most reached the hospital in critical condition.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 098820.Article de périodique
Bugalho A.; Bique C.; Almeida L.; Bergstrom S.
Application of vaginal misoprostol before cervical dilatation to
1994 - Obstetrics and Gynecology, 83(5 Pt 1), p. 729-731
Mots clés : méthodologie; enquête; Misoprostol; méthode; médicament; dilatation curetage; méthode; étudiant; scolarisation; avortement; contraception d'urgence; contraception postcoitale; planning familial; traitement; soin
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : During October-November 1992 in Mozambique, hospital staff randomly allocated 100 women choosing to undergo 1st trimester pregnancy termination at Maputo Central Hospital into a group receiving 200 mcg misoprostol or a group receiving a placebo in the posterior vaginal fornix 6 hours prior to cervical dilatation. The researchers used a per oral tablet of misoprostol, which is marketed to treat peptic ulcers. Women in the misoprostol group experienced cervical bleeding when the physicians started mechanical cervical dilatation (6 hours after vaginal application of misoprostol or placebo) at a rate of almost 9 times that of those in the placebo group (70% vs. 8%; odds ratio [OR] = 26.83), but the bleeding was minimal and did not need to be treated. Women in the misoprostol group were more likely to already have fetal or chorionic tissue in the vagina right at 6 hours after vaginal application than were those in the placebo group (22% vs. 2%; OR = 13.82). Six hours after vaginal application, more women in the misoprostol group had already had cervical dilatation to Hegar 8 than did those in the placebo group (74% vs. 10%; OR = 25.62). The average time required from the beginning of dilatation until the completion of vacuum aspiration was significantly shorter for the misoprostol-treated women than for the placebo treated women (2.7 vs. 4.1 minutes; p < 0.004). Nurses can effectively place misoprostol in tablet form into the vagina. As these findings show, vaginal application facilitates subsequent vacuum aspiration as well as reduces the time of uterine evacuation. These points and the low cost of misoprostol make misoprostol an attractive prostaglandin preparation to induce cervical softening.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 099045.Rapport
Anonymous
Assessment of unsafe abortion in Africa. Summary of six country profiles: Kenya, Zambia, Ghana, Nigeria, Senegal, Cameroon
1994 - 30 p
Mots clés : complication; loi; demande; attitude; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; psychologie; facteur psychologique; comportement
Pays / Régions : Kenya; Zambie; Ghana; Nigeria; Sénégal; Cameroun; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Afrique de l'Ouest; Afrique Francophone; Afrique CentraleRésumé : In 1993, the International Planned Parenthood Federation initiated research on abortion in Kenya, Zambia, Nigeria, Ghana, Senegal, and Cameroon to assess the factors surrounding unsafe abortion. Profiles were drawn for each country which analyze the legal and social contexts of abortion and provide an understanding of the dimensions of the problem: who are the clients and providers, why do women seek abortion, what are the costs of abortion, and what can be done (particularly in terms of clarifying the linkages between abortion and contraception). Data were collected for Kenya and Zambia through a comprehensive review of the literature. For Ghana and Nigeria, interviews were used, and for Senegal and Cameroon a brief literature review was coupled with data from focus groups. This document contains summaries and highlights of these reports.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 103686.Article de périodique
Baboo K.S.; Ahmed Y.; Siziya S.; Bulaya R.
Characteristics of women terminating pregnancies at the University Teaching Hospital, Lusaka, Zambia
1994 - Cent Afr J Med, 40(5), p. 110-113.
Mots clés : méthodologie; enquête; loi; grossesse; contraception; méthode contraceptive; demande; avortement; contraception d'urgence; contraception postcoitale; planning familial; population; facteur démographique; facteur économique
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : During March-May 1993 in Zambia, interviews with 200 women aged 15-45 attending a gynecologic clinic at the University Teaching Hospital in Lusaka and a review of their medical records were conducted to determine the characteristics of women undergoing legal abortion and reasons they opted to terminate their pregnancy. Mean gestation age was 8.3 weeks. 3 women had a gestation of over 12 weeks. 56.5% of the women were not married (never married, divorced, or widowed). 15.9% of the unmarried cases were students. 70% of the women had completed secondary education. 81.5% knew about contraception. 52.5% of all women did not use contraception. 18.5% of them were not familiar with contraception. The reasons for terminating the pregnancy were: never married/divorced/widowed (47.5%); satisfied parity (24%); small child in school (16%); still in school (9%); and marital problems (3.5%). Women who had had a previous pregnancy were more likely to undergo legal abortion than women who had had no previous pregnancy (71% vs. 29%). 5% of all clients had had 1 previous abortion. 1% had 2 previous abortions. The low contraceptive use among these women suggests the need for expanded family planning education and contraceptive availability for all persons, even students, which should reduce the need for abortion. .
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 102311.Article de périodique
Dalla Zuanna G.
Contraception and abortion at the threshold of the year 2000: comparing rich and poor countriesContraccezione e aborto alle soglie del 2000: paesi poveri e paesi ricchi a confronto
1994
Mots clés : contraception; méthode contraceptiveRésumé : This is a collection of six papers given at a symposium on contraception and abortion sponsored by the demographic department of the University of Rome, held in Rome in November 1994. Each paper summarizes the role of contraception and abortion in a particular area of the world: Sub-Saharan Africa, the Muslim countries, Asia, Latin America, the developed countries, and Italy. There is also a statistical appendix containing, for countries around the world, data on general demographic indicators, fertility, maternal and infant mortality, abortion, and contraception by type.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - IND RH6C052.Article de périodique
Bouslama F.; Boukhris M.M.; Azzouzi A.; Meddeb S.
Contraception and unwanted pregnancy. 139 casesContraception et grossesses non desirees. A propos de 139 cas
1994 - Tunisie Medicale, 72(10), p. 567-570
Mots clés : méthodologie; grossesse non prévue; grossesse non désirée; échec de contraception; abstinence; Ogino; contraception; IEC; information éducation communication; avortement; santé de la reproduction; fécondité; population; facteur démographique; contraception; méthode contraceptive; planning familial; comportement; programme; contraception d'urgence; contraception postcoitale
Pays / Régions : Tunisie; Afrique Francophone; Afrique; Afrique du Nord; Pays arabes; Pays MéditerranéensRésumé : In Tunisia, midwives completed a questionnaire on 139 women aged 20 to more than 40 years who came to the Nabeul Regional Family Planning Center between October 1992 and April 1993 for an induced abortion so researchers could determine causes for unwanted pregnancies. Most women were between 25 and 39 years old. The highest proportion of unwanted pregnancy cases occurred in the 30-34 age group (34.53%). 13.66% of women in this age group conceived due to failure of the rhythm method. All but 12.2% of all women lived in an urban or semi-urban area. 68.1% had at most a primary education. 69.06% did not work outside of the home. Among all women, the leading reasons for the unwanted pregnancy were: failure of the rhythm method (42.4%); rest period between periods of modern contraceptive use (12.2%); and poor compliance with oral contraceptive (OC) use (11.5%). IUD expulsion was responsible for the unwanted pregnancy in two cases. These findings point to the need for an information, education, and communication (IEC) project to better explain correct use of the rhythm method and of OCs and to inform women that no rest period is needed between periods of modern contraceptive use. The IEC project should also educate older women about the maternal and fetal risks of pregnancy and delivery.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 112563.Article de périodique
Anonymous
Country paper on The Gambia
1994
Pays / Régions : GambieRésumé : The legal status of abortion in The Gambia is ambiguous. Although the country has not yet developed its own legislation pertaining to abortion, it is theoretically bound to the English Offenses Against the Person Act of 1961. On the other hand, as an Anglophone African country, Sections 198 and 199 of the Penal Code that permit abortion when necessary to save the life of the mother also apply. The cost of a private clinic abortion in The Gambia ranges from US$50-100; at a government hospital the cost is about $12. Thus, the majority of abortions are performed by lay people in nonmedical settings. Given the high incidence of clandestine abortion, it is not possible to estimate the number of procedures performed each year. However, official records indicate that 1635 induces abortions were performed in government hospitals in 1989. Although family life education is taught in many middle schools, adolescents from urban and peri-urban areas are believed to comprise the largest group of abortion seekers. Thus, it is recommended that this age group be targeted for interventions aimed at reducing the need for unsafe abortion, including greater access to contraception, intensified sex education campaigns, and financial aid to enable teenagers to abort in hospitals.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 094223.Article de périodique
Anonymous
Debate on the legalization of abortion in Zimbabwe
1994 - Women's Global Network for Reproductive Rights Newsletter, 45), p. 18-19
Mots clés : loi; complication; mortalité maternelle; femme; pro-avortement; avortement; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique; facteur politique
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Zimbabwe, where over 70,000 illegal abortions are performed each year and complications from clandestine abortion are a leading cause of maternal mortality, the abortion law debate has been re-opened. Under the present law, abortion is legal only to save the life of the mother and women who undergo illegal abortion face strict criminal sanctions. Timothy Stamps, the Minister of Health and Child Welfare, has stated, "The first rights of a child are to be desired, to be wanted, and to be planned." Dr. Illiff, of the University of Zimbabwe's Department of Obstetrics and Gynecology, has noted, "We cannot stop abortion. The choice is how safe it is." Illiff pointed out that urban Zimbabwe women run a 262 times greater risk of dying of abortion complications than their counterparts in the UK where abortion is legal. As the Women's Action Group has observed, men have dominated the current debate on abortion. The group has issued an appeal to women to enter into this debate that concerns their bodies to ensure that another law is not imposed on them. The group's appeal for action states: "We as Women's Action Group believe that every woman should decide what's right and what's wrong in her life. She and only she should be the master of her destiny. Her voice should be heard louder than anyone else's."
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 096762.Article de périodique
Shapiro D.; Tambashe B.O.
Education, employment, and fertility in Kinshasa and prospects for changes in reproductive behavior
1994
Mots clés : enquête; déterminant fécondité; ville; résidence; éducation; activité économique; mariage; état matrimonial; contraception; méthode contraceptive; avortement; allaitement; abstinence post-partum; fécondité; population; facteur démographique; facteur socio-économique; facteur économique; nuptialité; état matrimonial; mariage; planning familial; contraception d'urgence; contraception postcoitale; santé; abstinence; contraception
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The results of the weighted multivariate regression analyses supported the notion of differential fertility by educational attainment and employment status among urban women in Kinshasa, Kenya. Higher educational levels, as well as employment in the modern sector, were associated with lower numbers of children ever born. Marriage age was affected by school enrollment status, but not employment status. Women with higher levels of schooling had shorter breast feeding durations; those working in the formal sector had slightly longer durations of breast feeding. There was an inverse relationship between postpartum abstinence and educational level. Religion, migration status, ethnic group, marital status, and economic status had an effect on fertility and its proximate determinants. Religion and ethnic affiliation may cancel each other out in terms of the effects on proximate determinants and fertility. Modern and informal sector employment must be distinguished in examining the links between employment and fertility. The policy implications were that fertility behavior will be limited with increased opportunities for women's schooling into the secondary level and employment. The low use of contraception among students warrants provision of contraceptive knowledge in the schools. Marital status should not be a determining factor in the availability of contraceptives for women. Data were obtained from a household survey conducted in 1990 among 2400 women aged 13-49 years in Kinshasa, Kenya, and stratified by high, medium, and low economic levels and sector of employment. Weighted ordinary least squares techniques were used in the multivariate analysis, due to the heavy oversampling of women employed in the modern sector.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 093326.Article de périodique
Singh S.; Deidre W.
Estimated levels of Induced Abortion in six latin American Countries
1994 - International Family Planning Perspectives, 20(1), p. 4-13
Mots clés : méthodologie; taux; complication; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; analyse
Pays / Régions : Amérique Latine; Chili; Mexique; Pérou; Amérique du Sud; Amérique; Amérique du NordRésumé : In countries where abortion is illegal, a range of approximate levels of induced abortion can be calculated from data on the number of women hospitalized for treatment of abortion complications, after correcting for underreporting and misreporting and adjusting to eliminate spontaneous abortions. An estimated 550,000 women are hospitalized each year as a result of complications from induced abortion in Brazil, Chile, Colombia, the Dominican Republic, Mexico, and Peru. About 2.8 million abortions are estimated to occur in these countries annually when women not hospitalized as a result of induced abortion are taken into account. If the situation in the six countries is assumed to be typical of the entire region, then about 800,000 women are probably hospitalized because of complications of induced abortion in Latin America in a given year, and an estimated 4 million abortions take place. The abortion rate most likely ranges from 23/1000 women aged 15-49 in Mexico to 52/1000 in Peru, and the absolute number ranges from 82,000 in the Dominican Republic to 1.4 million in Brazil. From 17% of pregnancies in Mexico to 35% in Chile are estimated to end in induced abortion. (author's)
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/.Article de périodique
Anonymous
Ethiopia country paper
1994
Mots clés : loi; complication; grossesse adolescente; grossesse; demande; adolescence; adolescent; facteur politique; prévalence contraceptive; offre contraception; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; jeune; adolescent; âge; contraception; méthode contraceptive
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : The Transitional Government of Ethiopia's issuance of a national population policy in 1993, establishment of a Women's Affairs Bureau within the Prime Minister's Office, and collaboration with the Family Guidance Association are indicative of a political commitment to family planning and reproductive health. However, use of modern methods of contraception is only 2-4% and illegal abortion is a major contributor to maternal mortality. Slightly more than half of pregnancies of Ethiopia are reported to be unwanted. While the Transitional Government has created a political climate favorable to family planning activities, only 46% of the population has access to any form of health care as a result of political turmoil, war, and a scattered geographic distribution. A serious result of the inaccessibility of contraceptive services has been a rapid increase in teenage pregnancy and clandestine abortion. Data from hospitals in Addis Ababa indicate that teenagers comprise about 21% of women presenting for treatment of complications from illegal abortion. Since abortion is highly taboo in Ethiopia, an estimated 92% of illegal abortions are performed by unskilled persons rather than health workers. The government has established a goal of reducing the total fertility rate from the current level of 7.4 to 4.0 by the year 2015 and to raise the contraceptive prevalence rate to 44% by strengthening and expanding family planning service delivery and training additional health manpower. Also needed is a commitment to reduce the incidence of illegal and unsafe abortion among young women through family life education in the schools, use of the mass media to disseminate information on family planning, greater involvement of nongovernmental organizations, and the promotion of women's equality in the areas of education, employment, and health.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 094222.Article de périodique
Mturi A.J.; Hinde P.R.
Fertility decline in Tanzania
1994 - Journal of Biosocial Science, 26(4), p. 529-558
Mots clés : enquête démographique et de santé; EDS; transition fécondité; déterminant fécondité; mariage; avortement; contraception; méthode contraceptive; stérilité; mariage; état matrimonial; éducation; enquête; population; facteur démographique; fécondité; état matrimonial; nuptialité; état matrimonial; mariage; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; facteur socio-économique; facteur économique
Pays / Régions : Tanzanie; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Analysis of 1991-92 Tanzanian Demographic and Fertility Survey and census data revealed that census fertility declined since 1978 from 7.2 children per woman to 6.5 for 1984 to 1988, based on the P/F ratio method. Fertility declined 12% between 1978 and 1988. The analysis of the proximate determinants of fertility according to the framework of Bongaarts and Bongaarts and Potter revealed that postpartum infecundability, which was significantly affected by breast feeding practices, lowered fertility. Late marriage, divorce and widowhood, and postpartum infecundability were the main factors in reducing fertility. Postpartum abstinence tends to be short in Tanzania and, thus, not a major factor in fertility decline. Contraceptive usage is low and induced abortion has a minimal effect on fertility. Multiple regression analysis of the sociodemographic factors in fertility decline indicated that infant and child mortality, the educational status of women, and delays in the marriage age are important factors in reducing fertility. These factors were all interrelated. The conclusion was that increased contraceptive use, which was affected by educational status, would be an important way to reduce fertility in Tanzania. The 1992 national population policy established the objective of reducing fertility, because of the high growth rate of about 3% annually. The study sample included 9238 women aged 15-49 years, and the data were considered reliable. The total fertility rate for this study was calculated differently from Egero and Henin based on the woman-child ratio. The assumptions were that all births were reported for the period July 7, 1966 to August 28, 1967 and that births were evenly distributed between 1967 and 1992. The Brass P/F ratio of 0.95 was used to adjust for error and underreporting during the study period. Ngallaba's P/F ratio of 1.125 used to calculate fertility. The child-woman ratio method produced fertility figures of 6.6 for 1967 and of 6.8 for 1978, indicating a modest decline. (© 1994 Cambridge University Press)
Source : source : journal of biosocial science http://titles.cambridge.org/journals/journal_catalogue.asp?historylinks=ALPHAmnemonic=JBS.Article de périodique
Leshabari M.T.; Mpangile G.S.; Kaaya S.F.; Kihwele D.J.
From teenage unwanted pregnancy to induced abortion: who facilitates links?
1994 - International Journal of Adolescence and Youth, 4(3-4), p. 195-210
Mots clés : enquête; complication; grossesse non prévue; grossesse non désirée; adolescence; adolescent; grossesse adolescente; grossesse; décision; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; jeune; adolescent; âge; comportement; famille
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Through use of a semi-structured interview schedule, the abortion decision-making process of 150 Dar es Salaam adolescents (mean age, 17.5 years) admitted with abortion-related complications was analyzed, with particular emphasis on the involvement of social networks. The male partner was the most frequent (47.3%) first confidant after pregnancy was suspected, followed by close relatives (35.1%) and girlfriends (14.0%). 62.0%, 41,7%, and 68.8% of these confidants, respectively, advised the teen to terminate the pregnancy; the remainder tended to express a lack of interest in her predicament. The link to an abortionist was provided by mothers, sisters, or aunts in 33% of cases, by the male partner in 32% of cases, and by girlfriends in another 24%. Male partners were more likely to provide funds for the abortion--especially if the woman was a student--than to help her access an abortionist. When abortion-related complications created a need for hospitalization, only 18% of male partners provided assistance; this burden fell upon female relatives. It is postulated that male involvement, beyond the provision of money, is inhibited by the potential legal and social consequences of illegal abortion in Tanzania.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 107396.Article de périodique
Bisrat F.; Pickering J.
High school students' knowledge, attitude and practice of contraception in Harer town, eastern Ethiopia
1994 - Ethiop Med J, 32(3), p. 151-159.
Mots clés : enquête; étudiant; scolarisation; école; scolarisation; risque; contraception; méthode contraceptive; loi; éducation; comportement; planning familial; avortement; contraception d'urgence; contraception postcoitale
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : A survey of knowledge, attitude, and practice of contraception was carried out among 1674 students (mean age 17.4 years) in Harer town, eastern Ethiopia. 54% of the students spontaneously mentioned a modern contraceptive method when asked, but large numbers of students did not know the answers to specific questions about prevention of pregnancy. The students were receptive to more information in schools on sexuality and contraception. Overall, 20% of females and 65% of males admitted to having had sexual intercourse at least once. Among sexually active females, 60% said they were using a contraceptive method. However, 76% of these were using only the calendar method. 20% of the sexually experienced female students had been pregnant, and of these 56% had elected for induced abortions. If only unmarried students are considered, 75% of those who had been pregnant had had an induced abortion. Since induced abortions are not legal in Ethiopia, these students are at high risk for complications from abortion. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101844.Article de périodique
Souleymane M.; Albatoure B.
High-risk abortions and their prevention in Niger
1994
Mots clés : loi; complication; adolescence; adolescent; offre contraception; avortement; contraception d'urgence; contraception postcoitale; planning familial; jeune; adolescent; âge; population; facteur démographique; contraception; méthode contraceptive
Pays / Régions : Niger; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Until 1988, Niger was governed by French statutes prohibiting both contraception and abortion. However, in view of unprecedented economic crises and a resultant increase in infanticide, abandonment of unwanted children, and illegal abortion, in 1984 Niger authorized contraception provision to married couples and in 1985 established a National Family Health Center. In 1988, the law was revised to permit contraceptive distribution, but abortion remained illegal under all circumstances. A 1991 attempt by the Department of Family Planning to extend contraceptive availability to unmarried adolescents without parental consent failed. This remains an important goal given the prevalence of premarital sexual activity, the dangers of clandestine abortion, and the risk of transmission of human immunodeficiency virus and other sexually transmitted diseases among unmarried youth.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094213.Article de périodique
Tadesse E.; Yoseph S.; Gossa A.; Bogarian D.; Muletta E.; Ketsella K.; Hawaz Z.
Illegal abortion at five hospitals in the city of Addis Ababa. World Health Organization (WHO) multi-centre survey by abortionist, methods used to terminate pregnancy, number of attempts made
1994
Mots clés : enquête; avortement; loi; étudiant; scolarisation; méthodologie; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : After an introduction and a review of the Safe Motherhood Initiative (SMI) in Ethiopia in terms of selected health indicators, selected health statistics for 1990, factors contributing to high maternal mortality rates, SMI strategies, SMI objectives, and the essential elements of obstetric care facilities, this paper reports on a 6-month cross-sectional survey on illegal abortion with data gathered through questionnaires in 5 hospitals in Addis Ababa. During the study period, 2275 cases of abortion were treated. 94 of the abortions were induced by medical doctors, 24 by nurse/midwives, 24 by gynecologists, 21 by pharmacists, and 306 by others. In addition, 366 abortions were self-induced. Most abortions took place in the abortionists' homes (60%), followed by patients' homes (35%), hospitals (1.8%), and doctors' offices (3.2%). Various methods were used, including inserting a plastic catheter, a plastic tube, a metallic rod, or a twig into the vagina and administering drugs. Most of the cases underwent only 1 abortion attempt, but 24% underwent 2 attempts, and the maximum number of attempts was 7. It was concluded that the prevalence of contraceptive usage must be increased, family life education must be introduced in schools, and educational opportunities must be expanded for girls. In addition, the Ministry of Health should take the appropriate actions against those who commit criminal acts.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 108277.Article de périodique
Temba P.; Nkya A.
In dark corners: illegal abortion in Tanzania
1994 - 21-32, 177-178
Mots clés : loi; mortalité maternelle; avortement; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Modern contraception has been legally available in Tanzania since 1959, but many women have very limited or no access. Formerly, only married women were allowed to use family planning services. In 1989, however, the Ministry of Health redefined eligibility to include any adult irrespective of marital status, but services were limited to couples or women with at least one child. Finally in December 1992, the government extended contraceptive services and supplies to all individuals who can either become pregnant or cause pregnancy. Even so, there is great unmet demand in Tanzania for both information on contraception and actual family planning methods. Many people in the country therefore have sexual intercourse without using contraception, or they experience contraception failure, and either become pregnant or cause pregnancy. Pregnant women who do not wish to carry an accidental conception to term may seek induced abortion. Young, single women looking to avoid the stigma of being a single mother and hoping to continue their education are especially likely to opt for abortion. Induced abortion in Tanzania, however, is a criminal offense unless performed by a physician to protect the health and life of the mother, in cases of fetal malformation, or of rape or incest. A woman who terminates her pregnancy can be imprisoned for seven years, anyone who performs an abortion may be imprisoned for up to fourteen years, and the supplier of abortion-inducing drugs can be imprisoned for three years. Despite the risk, it is commonplace for Tanzanian women, especially the young, ill-informed, and poor, to resort to illegal abortions outside of the health care system. 20% of women admitted to four public hospitals in Dar es Salaam with abortion-related problems were still pursuing their primary or secondary education. Further, hospital records show 10-12% of maternal mortality to be the result of induced abortion. The author considers abortion in Tanzania in the context of women's overall access to health care and their status in society. There is significant need for family planning education and supplies in Tanzania.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 106856.Article de périodique
Lema V.M.; Thole G.
Incomplete abortion at the teaching hospital, Blantyre, Malawi
1994 - East African Medical Journal, 71(11), p. 727-735.
Mots clés : complication
Pays / Régions : MalawiRésumé : A total of 444 women treated for incomplete abortion using the manual vacuum aspiration technique, at the Queen Elizabeth Central Teaching Hospital, Blantyre, between 10th January and 9th April, 1994, were interviewed by means of partially structured questionnaire, to determine among other things, their socio-demographic profiles, contraceptive behaviour, as well as associated complications.
Source : source :East African Medical Journal.Article de périodique
Bugalho A.; Bique C.; Machungo F.; Faundes A.
Induction of labor with intravaginal misoprostol in intrauterine fetal death
1994 - American Journal of Obstetrics and Gynecology, 171(2), p. 538-541
Pays / Régions : MozambiqueRésumé : Physicians at the Maputo Central Hospital in Mozambique inserted at least 100 mcg misoprostol into the vaginas of 72 women with intrauterine fetal death at 18-40 weeks pregnancy to induce labor. They inserted another dose every 12 hours up to 48 hours if a patient had not begun labor. The mean time between induction of labor to delivery stood at 12.6 hours. 92% delivered within 24 hours. All had delivered by 48 hours. The time between 1st dose and expulsion was significantly lower for women with a Bishop's score of more than 5 than for those with a score of 5 and lower (7.6 vs. 13.7 hours; p = .028). Bishop's score was the only variable associated with time to expulsion. (It is used to estimate the prospects of labor by evaluating the extent of cervical dilatation, effacement, station of the head, consistency of the cervix, and cervical position in relation to the vaginal axis.) No one died, needed surgery either before or after delivery, or suffered side effects. The physicians noted that this regimen greatly reduced costs, staff workload, and time. These findings suggest that intravaginal misoprostol at a dose of 100 mcg/12 hours is a safe, effective, practical, and inexpensive new way to induce labor in cases of intrauterine fetal death.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 098090.Article de périodique
Benson J.; Johnson B.R.; Nicholson L.A.
International abortion research: new environment, new priorities
1994
Mots clés : revue littérature; avortement; loi; épidémiologie; mortalité maternelle; soin post-abortum; information; contraception d'urgence; contraception postcoitale; planning familial; santé publique; santé; mortalité; population; facteur démographique; programme planning familial
Pays / Régions : Afrique Subsaharienne; Amérique Latine; Asie; AfriqueRésumé : The objectives were to review the published literature on abortion in three regions in order to identify gaps and recommend future research efforts. Databases were searched in-depth from sub-Saharan Africa covering 1980-94. Annotations were prepared on 99 articles dealing with epidemiology, clinical, cost, and legal issues, male perspectives, contraception, and postabortion family planning. Limited search of the abortion literature from Latin America and Asia for 1985-94 was also carried out, and abstracts were completed on 14 Latin American and 25 Asian articles. Major findings for 41 epidemiology studies from Africa revealed maternal mortality of 2-6/1000 live births; 18-35% of maternal mortality from abortion; 27-60% of gynecology admission attributable to abortion; sepsis and hemorrhage were the main causes of abortion with young women overrepresented in septic cases and abortion deaths; abortion patients were young, unmarried, and low parity was overrepresented. Findings from 19 clinical studies from Africa indicated the disproportionate impact of major complications on mortality and length of hospital stay; manual vacuum extraction had same or lower complication rates and same or better effectiveness as dilatation and curettage; sexually transmitted diseases and pregnancy-related infections were major contributors to infertility. Findings from 18 studies on abortion and the law from Africa showed narrow legal indications and restrictive laws, administrative barriers, and consequent detriment to women's health. Gaps in research in Africa included cost use of abortion complications, postabortion family planning, and male perspectives. The findings of 14 studies from Latin America demonstrated the social context of abortion, women's and providers' perspectives, and low contraception knowledge and use. Finding from 25 Asian studies revealed the focus on mortality rate and second trimester, family planning use prior to index abortion, and postabortion family planning. Recommended research topics consisted of impact of abortion, access to services, contraceptive use pre- and postabortion, underserved populations, new technologies, social context of abortion, and feasibility of legal reform.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101572.Rapport
Anonymous
International Conference of Parliamentarians on Population andConference Internationale des Parlementaires sur la Population et le Developpement, ICPPD '94, Le Caire, Egypte, Les 3 et 4 septembre 1994
1994
Mots clés : conférence population; population; santé de la reproduction; planning familial; avortement; genre; femme; santé; mortalité; facteur économique; contraception d'urgence; contraception postcoitale; facteur socio-économique; facteur démographique
Pays / Régions : Egypte; Pays arabes; Pays Méditerranéens; Afrique du Nord; AfriqueRésumé : Almost 300 parlementarians from 107 different countries convened in Cairo in 1994 to discuss population and development issues, as well as their respective policies. The positions of these conference attendees are described upon population and sustainable development, reproductive health, family planning, abortion, gender equality and women's independence, health and mortality, and the mobilization of resources to support population and development programs. Work group reports on these issues are presented, including a group report upon what parlementarians can do in their respective regions around the world. They issue a call to action. Participant lists are included at the end of the report.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 164971.Rapport
Koffi N.G.; M. P. K.; G. L S.
La planification familiale dans le département d'Aboisso (Sud-est de la Côte-d'Ivoire)
1994 - Rapport d'enquête, ENSEA, Abidjan, 137
Source : source Ceped http://ceped.cirad.fr.Congrès
IPPF
Les avortements à risque et la planification familiale post-abortum en Afrique
1994 - Conference de Maurice, Centre international de conférence de Grand'Baie, 24-28 mars 1994, IPPF, 38p p.Résumé : In March 1994, more than 100 specialists from family planning associations (FPAs) and ministries of health participated in the IPPF-supported Conference on Unsafe Abortion and Post-Abortion Family Planning in Africa (sub-Saharan Africa) in Gran' Baie, Mauritius. It was designed to help FPAs and governments confront the public health and social problems caused by unsafe abortion. Topics discussed in the working groups were abortion and postabortion family planning services, role of support services in abortion and postabortion family planning services, counseling and contraceptive needs, and reducing the number of unsafe abortions. Working groups developed strategies and action plans to reduce the incidence of unsafe abortion in Africa. The estimated unsafe abortion rate in Africa is 23/1000 women aged 15-49, ranging from 12 in Middle Africa to 31 in Eastern Africa. In Nigeria, 50% of all maternal deaths are related to abortion. In Kenya, insertion of foreign bodies/instruments is the most common abortion method. In Benin, most abortion patients are married (70.5%) and Catholic (58.7%). No African country provides abortion on demand. Botswana, Ghana, and Zambia have the most liberal abortion laws (abortion allowed for social and sociomedical reasons). In countries where abortion services are legal, FPAs can produce a list of sympathetic health personnel, conduct a follow-up on women who have been denied safe abortion services, document where safe abortion services are withheld from some population groups, promote the use of newer abortion techniques, and provide training in safe abortion techniques. Many donor and technical cooperating agencies have made commitments and implemented initiatives to bring about safe abortion and postabortion family planning services in Africa, such as Family Health International and Johns Hopkins University's Center for Communication Programs.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 100699.Congrès
Caldwell J.C.; Caldwell P.
Marital status and abortion in Africa
1994 - Nuptiality in Sub-Saharan Africa : contemporary anthropological and demographic perspectivesSéminaire sur la Nuptialité en Afrique au Sud du Sahara : Changements en Cours et Impact sur la Fécondité, Paris (FR) 1988/11/14-17, New York (US), Oxford University Press, p. 274-295 p.
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Anonymous
Maternal and child health family planning and abortion in Madagascar
1994
Mots clés : enquête; santé; loi; complication; incidence; mortalité maternelle; contraception; méthode contraceptive; offre contraception; âge; avortement; contraception d'urgence; contraception postcoitale; planning familial; mesure; méthodologie; mortalité; population; facteur démographique
Pays / Régions : Madagascar; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Although therapeutic abortion is legal in Madagascar, 3 physicians must certify that the procedure is necessary to save the life of the mother. For other circumstances, the repercussions for providers who perform abortions are severe: 5 years' imprisonment and a stiff fine, 10 years' imprisonment and an even larger fine if it is established that the individual is a habitual provider, and possible withdrawal of one's license to practice or resident visa. For women who undergo an illegal abortion, the penal code specifies 6-24 months' imprisonment and a fine of 18-360,000 francs. Despite these sanctions, illegal abortion is widespread. Department of Health and Population statistics for 1988 indicate that 8934 women presented to hospitals in Madagascar in 1988 for treatment of complications related to clandestine abortions; 166 of these women died. Obviously, this statistic is a tremendous understatement of the extent of the problem and tends to be reflective of self-induced abortions. Procedures performed, without complications, by traditional doctors, midwives, and paramedics are not recorded. A Ministry of Health survey conducted in Malagasy identified the following age-specific abortion rates: 15-19 years, 18/1000; 20-24 years, 80/1000; 25-29 years, 136/1000; 30-34 years, 171/1000; 35-39 years, 162/1000; 40-44 years 141/1000; and 45-49 years, 102/1000 women. Yet another survey conducted in Malagasy found that 38% of women of reproductive age (45% of those 25-34 years of age) would pursue illegal abortion in the event of an unwanted pregnancy. 44% of couples in urban areas and 55% of those in rural Madagascar have already exceeded their desired family size, but only 17% overall use a contraceptive method (5% a modern method). Given the government's intransigence on easing restrictions on abortion, there is an urgent need to increase knowledge of and access to reliable contraceptive methods. At present, there are only 166 family planning service delivery sites in a country with a population of 12 million.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 094218.Article de périodique
Anonymous
Mauritius declaration
1994
Mots clés : avortement; loi; risque; planning familial; mortalité maternelle; contraception d'urgence; contraception postcoitale; santé publique; santé; mortalité; population; facteur démographique; service de santé; programme
Pays / Régions : Maurice; Afrique; Afrique de l'Est; Afrique Subsaharienne; Afrique Anglophone; Afrique FrancophoneRésumé : The participants from 20 African nations to the International Planned Parenthood Federation and the Mauritius Family Planning Association Conference on Unsafe Abortion and Post Abortion Family Planning in Africa recognize that: in most African countries abortion laws are restrictive, yet illegally induced unsafe abortion is a major cause of maternal mortality and morbidity; determining the size and spacing of the family is every individual's and couple's basic right; providing high quality, easily accessible and affordable family planning information and services for everyone of reproductive age is the surest way to reduce unsafe abortion and prevent maternal deaths. Therefore, they urge governments, parliamentarians, health care providers, religious leaders, women's organizations, communities and the media to stop the vicious cycle of unwanted pregnancy and unsafe abortion. Every day almost 10,000 African women undergo unsafe abortions and every day, many die. For each woman who dies many more suffer debilitating pain, illness, and infertility. It is resolved to: strengthen family planning information, education and services, including wider availability of emergency contraception particularly emphasizing male responsibility in family planning; increase availability of high quality emergency treatment for women with complications of unsafe abortions, and post abortion counselling and family planning services; provide appropriate abortion services for termination of pregnancy; review and work to liberalize restrictive abortion laws and minimize barriers to safe abortion; train health care providers in safe and appropriate technologies for treating abortion complications; link abortion treatment with family planning and other reproductive health care services in and out of hospitals to improve women's health care; and respect and respond to the needs and rights of youth to sexual and reproductive health education and services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 099501.Article de périodique
Anonymous
Method switching and not using modern methods lead to abortions in Mauritius
1994 - Progress in Human Reproduction Research, 29), p. 5
Mots clés : avortement; contraception; méthode contraceptive; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Maurice; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique Anglophone; Afrique FrancophoneRésumé : Contraceptive prevalence in Mauritius (76%) is among the highest in the world. Yet, it is estimated that each year there are some 20,000 cases of induced abortion, which is illegal in the country. A study based on a sample of 475 women admitted to three hospitals with complications due to induced abortion revealed considerable use of unreliable methods (e.g., withdrawal and natural methods), frequent method switching, and inconsistent use of modern methods. The study also found that women seeking abortion were usually under 30 years of age, and 20% of women with abortion complications were not using any method, and some 50% were using an unreliable method at the time they became pregnant. It emerged that with increasing numbers of women employed, their work schedules hindered their going to a family planning clinic and resulted in abortion being used as a back-up to contraception failure. Among the women with abortion complications, 25% had already had a previous abortion. These findings came as a big surprise to the family planning services. To discuss the findings, a national symposium was held in July, 1993. The symposium was attended by government ministers, members of parliament, and international personalities in the field of family planning. A discussion of the results of the study also took place in the National Assembly, where a motion was tabled to decriminalize abortion. The findings also facilitated, albeit indirectly, the approval of Norplant in the country. (full text)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 099518.Article de périodique
Anonymous
Misperceptions about contraceptives keep abortion incidence high in Ghana
1994 - Progress in Human Reproduction Research, 29), p. 3
Mots clés : méthodologie; enquête; croyance; perception; contraception; méthode contraceptive; effets secondaires contraception; avortement; information; culture; psychologie; facteur psychologique; comportement; planning familial; contraception d'urgence; contraception postcoitale; communication
Pays / Régions : Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Only 13% of couples in Ghana practiced contraception in 1988. During the period of nursing following childbirth, it is traditional for the new mother to abstain from sexual intercourse. She is subject to considerable social scorn should she conceive too soon after a previous delivery. Conceiving in short order, nonetheless, women long resorted to clandestine, unsafe abortions during the postpartum interval. The government of Ghana legalized the practice of induced abortion in 1985 so that women could limit their fertility in safety with registered and certified medical practitioners. The author studied 900 women seeking an induced abortion or reporting complications resulting from induced abortion performed outside a hospital setting to see why, in spite of high knowledge of contraception, Ghanaian women resort to abortion instead of using contraception. Subjects were recruited from the KorleBu Teaching Hospital in Accra, the Tema General Hospital of Tema, the Nsawam Hospital of Nsawam, and two abortion clinics in Accra. 55% were married, 25% were teenagers, and 56% were residents of Accra, while the rest were from rural areas. Among those who were married, 45% were the third wives. Most of the women had some formal education and some degree of economic independence. 99% knew of at least one method of contraception, only 21% had ever used a modern method, 6% had used a condom, 4% had used withdrawal sometimes, and 3% had used the rhythm method. The women reported not using modern contraceptives mainly because of the belief that they cause harmful side-effects. For example, it was commonly thought that the oral contraceptive pill causes infertility and withdrawal causes stroke in men. Women also viewed contraceptives as messy, complicated, and/or difficult to use. 54% said they decided to abort their fetus because the pregnancy was out of wedlock; single parenthood is stigmatized in Ghana. 25% decided to abort to better space their children.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 099575.Article de périodique
Anonymous
Monograph on abortion issues in east, central and southern Africa
1994
Mots clés : revue littérature; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : Abortion was identified at the November 1993 Conference for High Ministers for East, Central, and Southern Africa in Lesotho as a major cause of maternal morbidity and mortality. Specific actions to address the problem in the region were also recommended at the conference. To document the magnitude of the abortion problem in the region and in sub-Saharan Africa overall, the Commonwealth Regional Health Community Secretariat undertook a study in 1994 in which literature on abortion covering the period 1980-94 was reviewed and primary data collected from Zambia, Uganda, and Malawi. 99 published and 195 grey literature documents were reviewed. The data suggest that there is a high percent of incomplete abortion patients among all hospital gynecology admissions. The researchers also identified a need for more community-based studies. The clinical literature identifies hemorrhage and sepsis as the two most common complications of abortion. Data collected from the countries largely confirm findings in the comprehensive literature search.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 107675.Article de périodique
Kinoti S.N.; Gaffikin L.; Benson J.; Nicholson L.A.
Monograph on abortion issues in east, central and southern Africa with policy implications. Draft
1994
Mots clés : revue littérature; avortement; complication; mortalité maternelle; politique; programme; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; mortalité; population; facteur démographique
Pays / Régions : Afrique de l'Est; Afrique Centrale; Afrique Australe; Malawi; Ouganda; Zambie; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This monograph is based on a 1994 study conducted by the Commonwealth Regional Health Community Secretariat in Maseru, Lesotho, to document the extent of the public health problem posed by abortion in the region and to promote dialogue among health policy makers. Published and unpublished literature (1980-94) were reviewed, and primary data were collected from hospitals in Zambia, Uganda, and Malawi. The monograph opens with 1) an introduction which describes the situation and study background, 2) details of the study methodology, and 3) a review of the literature in which the 99 published and 195 unpublished articles are organized into the following topics: the magnitude of unsafe abortion, maternal mortality statistics, clinical studies, cost studies, the male perspective, contraception and abortion, and abortion law. Country synopses for the primary research done in Zambia, Uganda, and Malawi describe the data collection and major findings for each country. Overall conclusions are that 1) unsafe abortion is an enormous public health problem; 2) the morbidity and mortality associated with it affect women in the prime of their lives; 3) treatment of unsafe abortion demands large amounts of money and resources; 4) safe and effective treatment is usually offered only at large urban hospitals; 5) postabortion counseling and services are rare; 6) patients seeking treatment for abortion suffer long waits and overcrowded conditions and receive little information; and 7) restrictive laws lead to the proliferation of unsafe abortion. The policy implications of these findings concern improvements in the quality, accessibility, and availability of postabortion services and care as well as improvements in the legal environment. Recommended research topics include 1) operations research on improving quality and accessibility of care; 2) documentation of lost work-years and income due to abortion morbidity and mortality; 3) the social context relative to abortion and role of males in the abortion decision; 4) clinical studies on pain control, treatment regimens, and postabortion care; and 5) case studies describing experiences with safe legal abortions in other countries.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 107879.Congrès
Alihonou E.; Goufodji S.; Capo Chichi V.
Morbidity and mortality relating to induced abortions (a study conducted in hospitals of Cotonou, Benin in 1993).
1994 - Conference on Unsafe Abortion and Post Abortion Family Planning in Africa,, Mauritius, March 24-28, 1994., 14 p p.
Mots clés : enquête; complication; demande; planning familial; morbidité; mortalité maternelle; contraception; méthode contraceptive; avortement; contraception d'urgence; contraception postcoitale; programme planning familial; maladie; complication; mortalité; population; facteur démographique
Pays / Régions : Bénin; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : The high morbidity and mortality associated with clandestine abortion in Benin, where pregnancy termination is permitted only to save the life of the mother, represent a serious drain on hospitals' already inadequate resources. A 1-year study conducted at 3 hospitals in Cotonou seeks to define more explicitly the morbidity and mortality among women hospitalized for complications of illegal abortion, develop a profile of these women, identify factors that place women at risk of seeking a clandestine abortion, and quantify the manpower and financial costs to hospitals of treating these women. From July-October 1993 (the first 4 months of the study), 380 of the projected 1600 abortion patients required for the analysis were recruited. Among these initial subjects, the most common reasons for presentation at hospital were hemorrhage (77.1%), abdominal pain (37.1%), abortion in progress (15%), and fever (10.5%). 25.8% of cases appeared to be spontaneous rather than induced abortion. Only 19.7% were unmarried; the majority were in the 20-34 year age group. 32.1% had a primary education, 32.1% completed secondary school, and 2.7% were university graduates. 17.1% identified themselves as housewives; the largest occupational grouping was retailers (43.4%). 52.1% of subjects with an unwanted pregnancy had not been using a contraceptive method; the most commonly cited reasons were lack of knowledge of available methods (58.8%), husband's opposition (14.7%), and fear of side-effects (11.8%). In 56.9% of cases, the abortion was self-induced, generally through use of pharmaceutical products such as estroprogestatives, antimalarials, or antipyretics. There were 8 deaths in this group, yielding a mortality rate of 21/1000. The first 4 months of experience in this ongoing study indicates that most women hospitalized with abortion-related complications are reluctant to complete the questionnaire; moreover, midwives are often too busy to perform this task adequately. Thus, special interviewers have been recruited for the remaining 8 months of the study.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094220.Article de périodique
Rwebangira M.K.
Patient satisfaction with MVA services in Dar es Salaam: a survey report
1994Résumé : The purpose of this study in Tanzania was to assess the extent to which patients are satisfied with manual vacuum aspiration (MVA) services; assess the quality of information given to MVA patients; and learn about women's perspectives in order to adapt services to their needs. The study was conducted between December 1993 and February 1994 at the referral hospital in Dar es Salaam, Muhimbili Medical Centre, and at the Ilala, Temeke, and Mwananyamala district hospitals. Patients who had been treated for abortion complications with MVA, who were about to leave the clinic/hospital, and who were willing to answer questions were administered a short questionnaire about the quality of care that they received, including: quality of information; postoperative care; hospital environment; pain during treatment; postabortion family planning (FP); and cost of services. Because there were very few patients at these centers the days of the interviews and because there were shortages of particular equipment or cannulae sizes at some centers, leading providers to not treat women with MVA even if they were medically eligible for it, the sample size consists of only 10 patients (3 from Ilala, 3 from Temeke, 2 from Mwananyamala, and 2 from Muhimbili). The patients' perspectives can be summarized as follows: 1) patients were inadequately informed about the treatment; 2) most women felt that the privacy was adequate given the circumstances; 3) some women wished the hospitalization period (waiting period) was shorter; 4) few patients were given information about post-treatment care; 5) perceptions of pain management were mixed, with 2 women reporting severe pain; 6) many were disgruntled about the existence of and variation in the financial cost, since MVA services are supposed to be free; and 7) MVA patients were not counseled on postabortion FP or referred for methods. The author concluded that the providers in attendance at the self-assessment of services meeting at which this paper was presented should address these issues during their strategy-setting sessions.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101362.Article de périodique
Okonofua F.E.; Onwudiegwu U.; Odutayo R.
Pregnancy outcome after illegal induced abortion in Nigeria: a retrospective controlled historical study
1994 - African Journal of Medicine and Medical Sciences, 23(2), p. 165-169
Mots clés : enquête; loi; curetage; méthode; complication grossesse; âge; étudiant; scolarisation; méthodologie; avortement; contraception d'urgence; contraception postcoitale; planning familial; intervention chirurgicale; méthode; intervention chirurgicale; traitement; soin; maladie; complication; issue grossesse; grossesse; santé de la reproduction; mortalité; population; facteur démographique; fotus
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Researchers compared data on 46 women with a history of illegal induced abortion with data on 53 women with no previous pregnancy to examine the effect of previous abortion(s) on subsequent pregnancy outcome. All 99 women delivered at the Obafemi Awolowo University Teaching Hospital in Ile-Ife, Nigeria, during January 1984-December 1988. The type of illegal induced abortion was dilatation and curettage (DC) which tends to cause cervical incompetence. Controls were more likely to suffer from preeclampsia than cases (11.3% vs. 2.1%; p < 0.05). Women with a history of induced abortion were more likely than the controls to suffer premature rupture of fetal membranes and preterm labor (23.9% vs. 1.8%, p < 0.001 and 32.6% vs. 9.4%, p < 0.0001, respectively). Gestational age was shorter in the study group than in the control group (median, 36 vs. 39 weeks; p < 0.01). Cases were more likely than controls to have smaller newborns (2.2 vs. 2.8 kg; p < 0.01) and more low birth weight newborns (41.3% vs. 17%; p < 0.01). Perinatal mortality was 23.9% in the study group compared to 1.8% in the control group (p < 0.001), mainly due to prematurity. Gestational age at termination did not effect the risks of premature rupture of membranes, preterm labor, low birth weight, or perinatal mortality. These findings show that illegal abortion has adverse effects on outcome of subsequent pregnancies. Physicians should determine whether a pregnant woman has had an illegal abortion. If so, they should monitor her for cervical incompetence so they can treat it early. Clinicians performing abortions should use vacuum aspiration rather than DC to reduce the likelihood of premature labor and perinatal death in subsequent pregnancies.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 109102.Article de périodique
Ejiro Emuveyan E.
Profile of abortion in Nigeria
1994
Mots clés : enquête; complication; incidence; adolescence; adolescent; grossesse adolescente; grossesse; demande; âge; mariage; attitude; connaissance, attitude; pratique; CAP; contraception; méthode contraceptive; grossesse non prévue; grossesse non désirée; avortement; contraception d'urgence; contraception postcoitale; planning familial; collecte; méthodologie; mesure; jeune; adolescent; population; facteur démographique; santé de la reproduction; fécondité; état matrimonial; nuptialité; état matrimonial; mariage; psychologie; facteur psychologique; comportement
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : At least 700,000 illegal abortions are performed in Nigeria each year, 70-80% of which involve teenage secondary school or university students. To gain insight into the attitudes and behaviors of Nigerian women, focus group discussions were conducted in Lagos between December 1993 and January 1994. The 72 female participants were divided into 6 groups. Adolescent participants cited a desire not to interrupt their education, fear of parental disapproval, or lack of support from boyfriend as reasons they would abort an unplanned pregnancy, while married women would consider abortion in cases of too many existing children, too short a birth interval, or a pregnancy resulting from an extramarital affair. Teenagers were more likely than married women to indicate they would go to a midwife, chemist, or friend to perform the abortion, largely due to financial reasons. Women 20-45 years of age had accurate knowledge of the signs of abortion-related complications and indicated they would seek medical attention in such a case; teenagers, however, were not only unknowledgeable about these danger signs but also reported they would be more likely to run away from home than report their complications to their parents or present to a health facility. Teenagers and single women in their 20s had more liberal views toward abortion than married women; however, the majority of group participants opposed legalization or liberalization of abortion due to religious views of abortion as murder and concerns promiscuity would be encouraged. On the other hand, support for sex education and family planning services in the schools, as a means of preventing illegal abortion, received broad support. Single women were most knowledgeable about methods of fertility control, while teenagers were the least informed; virtually none of the women in any age group could define what constituted a safe time of the menstrual cycle. Although religious beliefs are an obstacle to abortion law reform in Nigeria, these group discussions indicate support for improved availability of modern methods of fertility control in a country where the contraceptive prevalence rate is only 8%.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094226.Article de périodique
Anonymous
Programme's research on determinants of abortion has impact on policy
1994 - Progress in Human Reproduction Research, 29), p. 1
Mots clés : politique; programmeRésumé : Induced abortion remains a relatively uncharted research topic in medical demography, social science, and to a lesser extent, in epidemiology. Up to 20% of the 500,000 maternal deaths which occur annually throughout the world, however, may be a consequence of complications of unsafe abortion procedures. The UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction started a number of studies in 1989 in developing countries on the determinants and consequences of induced abortion. The program's research has produced a wealth of data, with many countries taking important steps to change abortion policy in the interest of improving reproductive health. For example, a study in Mauritius of women hospitalized for abortion revealed that 20% of them had not been using a method of contraception when they became pregnant; a motion was subsequently tabled in the National Assembly to decriminalize abortion. Another study in Chile showed the incidence of induced abortions to be generally under-reported by women and that interventions based upon sound policy can reduce their incidence and improve reproductive health.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 099577.Article de périodique
Olowu A.
Psychology and family planning
1994 - Women's Behavioural Issues, 1(1), p. 1-4
Mots clés : psychologie; facteur psychologique; planning familial; grossesse non prévue; grossesse non désirée; avortement; mortalité maternelle; complication grossesse; décès foetal; malformation congénitale; malformation foetus; counseling; santé de la reproduction; fécondité; population; facteur démographique; contraception d'urgence; contraception postcoitale; mortalité; maladie; complication; malformation; culture; clinique; hôpital; service de santé; programme
Pays / Régions : Nigeria; Afrique; Afrique de l'Ouest; Afrique Subsaharienne; Afrique AnglophoneRésumé : This paper examines the psychological aspects of family planning. Additionally, the WHO technical report series (No. 442) is discussed. The article also identifies the psychological barriers to the spread of information on contraception. According to the report, about 10% of pregnancies are unplanned. High maternal mortality and morbidity rates are observed in illegal abortions. Moreover, higher parity have been associated with several pregnancy complications, nutritional deficiencies in the mother, and increasing fetal deaths. This further strengthens the resolve of the organization to incorporate integrated family planning into family health services. After the Second World War, striking changes in family planning had taken place. Education and women's liberation have all contributed to the acceptance of contraception and the reduction of infant mortality. Traditions still play a part in the selection of contraceptive methods in several countries, and misconceptions about these methods were oftentimes not clarified because it is considered as sexual taboos. The study concludes that medical personnel, teachers, and parents play a vital role in the information campaign and the change of preconceived ideas on contraception.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 144970.Rapport
Nations Unies
Rapport de la Conférence Internationale sur la population et le développement.
1994 - Nations Unies, Le Caire,Résumé : This document, which is also available in Arabic, Chinese, French, Russian, and Spanish, is a preliminary version of the report from the conference held in Cairo. It includes the text of resolutions adopted by the conference, which consists primarily of the program of action agreed upon during the conference, together with a number of administrative details. (ANNOTATION)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - IND 803021.Rapport
Anonymous
Removing legal and policy barriers affecting delivery of family planning services in the Africa Region. Research framework for use by local researchers
1994 - 6
Mots clés : méthodologie; programme planning familial; soin; programme; facteur politique; politique; programme; avortement; femme; planning familial; santé; contraception d'urgence; contraception postcoitale; facteur socio-économique; facteur économique
Pays / Régions : AfriqueRésumé : A research framework is proposed to foster the compilation and analysis of existing laws and policies in African countries so that their impact on the delivery of family planning (FP) services can be assessed. The subject of the research work has been selected to reflect the International Planned Parenthood Federation's Strategic Plan with special attention paid to its first goal and its second, third, and fourth objectives. Therefore, the laws, regulations, and policies to be reviewed and analyzed will be those affecting 1) the legal status of women, 2) abortion, and 3) the accessibility of FP information and services (particularly to women and youth). When researching the legal status of women, the following lines of inquiry may be appropriate and relevant: 1) the status of official adherence to international conventions and protocols; 2) marriage and divorce; 3) polygamy; 4) rights within and upon dissolution of marriage; 5) personal rights; 6) property rights; 7) education and training; and 8) employment rights. For abortion, information should be gathered on the following aspects of the present status of the law: 1) constitutional provisions; 2) legislation; 3) judicial decisions; 4) authoritative texts; and 5) administrative guidelines or policies (the scope of any permissible abortions, the categories of any persons legally qualified to perform abortions, where should abortions be performed and under what conditions, what approval procedures must be followed, what circumstances govern the requirement of consent, and possible strategies for abortion law reform). The accessibility of FP services should be researched to discover the status of 1) the dissemination of information, 2) the provision of contraceptive services, 3) restrictions on place of sale or distribution, 4) the role of health and auxiliary personnel, 5) information and services for adolescents, and 6) sterilization. Before embarking on this research, a review of the national population policy and Strategic Plan of the Family Life Association of Swaziland will facilitate the identification of laws and policies that are actual or potential barriers to the delivery of FP services. After this research is completed (by the end of October 1994), a workshop is planned to discuss the results.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 108276.Article de périodique
Njau W.
Review of literature on adolescent youth sexual and reproductive health
1994
Mots clés : revue littérature; adolescence; adolescent; fécondité; santé de la reproduction; grossesse non prévue; grossesse non désirée; prévalence contraceptive; maladie sexuellement transmissible; MST; IST; VIH; sida; avortement; politique; jeune; adolescent; âge; population; facteur démographique; santé; contraception; méthode contraceptive; planning familial; IST; MST; infection; complication; maladie; complication; maladie; contraception d'urgence; contraception postcoitale
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This literature review highlights issues that affect adolescent and youth reproductive health in Kenya. It seeks to increase the knowledge of policy makers, community leaders and youth sector about the consequences of unwanted pregnancies, sexually transmitted diseases (STDs) and HIV/AIDS among Kenyan youth. The following issues are explored: fertility, sexual activity, teenage pregnancy, consequences of pregnancy, abortion, STDs, drug and substance abuse, contraceptive prevalence among adolescents, and sexual information. It is noted that young people are actively involved in sexual activities and initiate coitus as early as 13 years old. They engage in unsafe and unprotected sexual intercourse, but their knowledge and awareness of sexual information and contraceptive use is low. Moreover, studies evidenced that young people are users and abusers of many kinds of drugs and substances. Overall, the review shows that the youth are an abandoned and neglected group in terms of service provision. Thus, clear, supportive and progressive policies are needed to deal with most of the health related problems these young people are encountering. Implications of these findings for policy makers, community leaders, and the youth are discussed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 149942.Article de périodique
Agyei W.K.; Mukiza Gapere J.; Epema E.J.
Sexual behaviour, reproductive health and contraceptive use among adolescents and young adults in Mbale district, Uganda
1994 - Journal of Tropical Medicine and Hygiene, 97(4), p. 219-227
Mots clés : enquête fécondité; sexualité; santé de la reproduction; contraception; méthode contraceptive; adolescence; adolescent; grossesse adolescente; grossesse; connaissance, attitude; pratique; CAP; avortement; taux fécondité; fécondité; population; facteur démographique; comportement; santé; planning familial; jeune; adolescent; âge; contraception d'urgence; contraception postcoitale
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A 3-phase adolescent fertility survey was carried out in Uganda starting in 1988. This report presents data from household and individual questionnaires collected in Mbale District for the third phase in August 1990. 1357 adolescent and young adult respondents (15-24 years old) comprised the sample (146 urban males, 330 urban females, 356 rural males, and 525 rural females). Information was solicited on education, religion, employment, marital status, age at first intercourse, frequency of intercourse, number of partners, pregnancy, abortions, and childbearing, sexually transmitted disease experience and knowledge, and contraceptive knowledge and use. It was found that most of these young people were sexually active, and many initiated sexual activity before age 15 years. Most reported having received information about reproductive health, but few could identify the safe period in a woman's menstrual cycle. There were contradictions between behavior and attitudes, with many more young people reporting that they engaged in sexual behavior than reporting that they approved of premarital sex. Whereas levels of contraceptive knowledge were quite high, actual usage was very low. The condom, oral contraceptives, and rhythm method were most often used, but many respondents stated that they lacked enough knowledge to use contraceptive, they believed contraceptives were not safe, or contraceptives were not accessible to them. It is recommended that more educational programs be devised to counter the factors which will encourage high fertility in this population.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 099276.Article de périodique
Naik R.T.
Speech
1994
Mots clés : complication; santé de la reproduction; programme planning familial; grossesse non prévue; grossesse non désirée; femme; planning familial; avortement; contraception d'urgence; contraception postcoitale; santé; fécondité; population; facteur démographique; facteur socio-économique; facteur économique; éducation
Pays / Régions : AfriqueRésumé : In his introductory remarks to the Conference on Unsafe Abortion and Post-Abortion Family Planning in Africa, R.T. Naik, Chairman, noted that an ideological perspective on abortion has impeded recognition of women's health needs. The conference was sponsored by the International Planned Parenthood Federation (IPPF) Africa Region in collaboration with the IPPF International Office and the Mauritius Family Planning Association. Naik reported that the population growth rate in Mauritius has decline to 1.38% (1992) as a result of economic development, improvements in women's status, and aggressive family planning outreach and education. Nonetheless, about 2500 women are treated each year for complications related to illegal abortion. Despite the best of family planning programs, not all women are able to find an appropriate contraceptive method or use a method consistently and correctly over the reproductive life span. Of concern is the disproportionate burden an unwanted pregnancy places on women. Progress toward women's equality will be limited as long as women are coerced into motherhood by laws and penal codes that fail to take into account their role in social and economic development.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094217.Article de périodique
Pazie A.J.
State of unsafe abortion in Burkina Faso
1994
Mots clés : enquête; complication; grossesse adolescente; grossesse; adolescence; adolescent; demande; morbidité; mortalité maternelle; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; jeune; adolescent; âge; maladie; complication; mortalité
Pays / Régions : Burkina Faso; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : In 1989, 5% of women admitted to maternity wards of hospitals in Burkina Faso, where abortion is illegal under any circumstances, have serious complications related to illegally induced abortions. 70% of these women are 16-24 years of age; 80% are students or unemployed women. For 45%, it was their first abortion; however, 18% underwent multiple illegal abortions in one year. 25% of the procedures were performed in the second trimester of pregnancy. Nurses and traditional healers are the major providers of abortion; dilatation and curettage without anesthesia, insertion of objects into the cervix to rupture the amniotic membranes or of potassium permangante suppositories into the vagina, and plant concoctions administered orally are the primary methods used to induce abortion. Retention of products of conception occurs in 21% of cases, producing hemorrhage and infection. 80% of hospital-treat abortion complications involve cervical or vaginal trauma resulting from the use of suppositories; uterine perforation is also frequent. 6% of women presenting to the Ougagadougou health service and 7% of those treated at Bobo-Dioulasso Hospital died from hemorrhage, pelviperitonitis, septicemia, renal failure, or hepatitis associated with the illegal abortion. Also of concern are long-term complications; 35% of women presenting at Bobo-Dioulasso Hospital for treatment of infertility report a history of illegal abortion. Religious proscriptions make it unlikely that even restricted legal abortion will be available in Burkina Faso in the near future; however, the government actively seeks to make affordable contraception accessible at health and social centers, and secondary schools and colleges teach sex education. Since young women comprise the majority of illegal abortion seekers, it is recommended that the obstacles to contraceptive use among this group be identified, youth clubs become involved in the provision o information on contraception, and the sex education curriculum place greater emphasis on the dangers associated with premarital sexual activity.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094214.Article de périodique
Anonymous
Study quantifies problem of abortion in the region
1994 - Crhcs News, 6), p. 5
Mots clés : politique; complication; santé publique; risque; contraception d'urgence; contraception postcoitale; planning familial; santé
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : Findings of a multicenter study that was discussed during the 1993 Health Ministers' Conference showed that about 30% of maternal deaths in east, central, and southern Africa were associated with complications of unsafe abortion. The Commonwealth Regional Health Community Secretariat in collaboration with the Support for Analysis and Research in Africa, a project funded by USAID and the Johns Hopkins Program on Training in Reproductive Health, has coordinated a study that will help guide the development of better policies on unsafe abortion. One phase involved the collection and analysis of all published and unpublished information from computer data bases dealing with the problem. The other phase involved interviews with health care workers, patients, and managers of health care facilities in Zambia, Malawi, and Uganda. In each of the 3 countries primary data was collected from a tertiary care hospital in the capital city, a provincial hospital, and 2 rural district hospitals. The results of the primary data component showed that services for the prevention of unwanted pregnancy and treatment of complications of abortion in this region are inadequate. Unsafe abortion was also a major public health problem in the region, costing national governments a lot of resources. Findings revealed that unsafe abortion is an enormous public health problem with staggering consequences for women and the health care system, which spend an inordinate amount of money, time, and other resources to treat the consequences of unsafe abortion. Complications leading to acute and chronic injuries and sometimes death, as a result of unsafe abortion, affect women at the prime of their lives. Postabortion family planning services, health care facilities, and counseling are lacking. The Recommendations and Policy Implications of the study will be discussed by the 22nd Conference of Health Ministers with a view to developing specific actions to avert the problem.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 108259.Article de périodique
Krolikowski A.; Janowski K.A.; Larsen J.V.
Termination of pregnancy using extra-amniotic prostaglandin F2a - experience in a peripheral hospital
1994 - Central African Journal of Medicine, 40(8), p. 204-206
Pays / Régions : Afrique du SudRésumé : Extra-amniotic injection of prostaglandin F2a has proved to be an effective method of termination of pregnancy, although its use has been associated with serious complications including rupture of the uterus and maternal death. In this retrospective study of 45 patients who required termination of pregnancy in Eshowe Hospital for intra-uterine death or missed abortion two patients developed minor complications of this method. Forty four patients aborted between four hours 30 minutes and 18 hours 15 minutes after the injection. There was one patient who had a failed induction and who developed serious sepsis. It is not clear whether the sepsis was a result of the method used to induce labour or whether it was the primary pathology causing the intrauterine death and failed induction.
Source : source : Central African Journal of Medicine.Article de périodique
Mosaase M.L.; Tlebere P.
The case of Lesotho
1994
Mots clés : planning familial
Pays / Régions : LesothoRésumé : This paper has been based on the best available information, but the author's ability to present a true picture of unsafe abortion and postabortion family planning (FP) in Lesotho has been hampered by a lack of empirical data. The maternal mortality rate in Lesotho is estimated at 220/100,000, with 25-33% of maternal deaths estimated to be secondary to abortion. Abortion, which is illegal without exception, is the most common admission diagnosis at the main referral hospital in Lesotho (640/1185 in 1992 and 749/1384 in 1993). While knowledge of FP is high (estimated to be 95%), actual use is estimated at 18.5%. It is also thought that husbands are believed to generally disapprove of contraception use. In addition, the predominately Catholic Private Health Association of Lesotho has no natural FP counseling in place, and there is a woeful lack of FP services for adolescents. The following strategies are proposed to improve the situation: 1) expansion of maternal health and FP services; 2) increasing health education; 3) the provision of FP services for adolescents; 4) the empowerment of women; 5) the promotion of research in health and related issues; 6) the institution of compulsory education; 7) the reform of health statutes, laws, and policies; and 8) the establishment of appropriate procedures and methods (including manual vacuum aspiration) to help reduce the waiting time for hospitalized abortion patients.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 108273.Article de périodique
Likwa R.N.; Whittaker M.
The characteristics of women presenting for abortion and complication of illegal abortions at the University Teaching Hospital, Lusaka, Zambia -- an explorative study
1994
Mots clés : enquête; loi; complication; demande; incidence; mortalité maternelle; contraception; méthode contraceptive; programme; planning familial; avortement; contraception d'urgence; contraception postcoitale; mesure; méthodologie; mortalité; population; facteur démographique; programme planning familial
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In contrast to most sub-Saharan African countries where abortion is severely restricted, Zambia allows abortion in cases where continuation of the pregnancy would involve risk to the life of the mother or the mental health of her existing children or there is a strong likelihood of congenital abnormalities. In 1983, according to the Zambian Ministry of Health statistics, 1164 legal abortions were performed in the country's hospitals. However, the same source reports that 16,977 women were treated at hospitals for complications of illegal abortion in 1983 and this statistic continues to rise. In part, this is due to the inaccessibility of legal abortion services in areas of the country outside of the capital city of Lusaka; other areas lack the hospital facilities and gynecologists to grant legal abortion requests, per the 1972 Termination of Pregnancy Act. To determine whether there are, in addition, differences in the sociodemographic characteristics of legal versus illegal abortion patients, a prospective study compared 199 Lusakan women granted a legal abortion and 65 hospitalized with complications of an illegal abortion. Legal abortion patients tended to be in the 20-29 year age group (55%), have some secondary education (60%), and to be multigravidae (71%); illegal abortion patients were predominantly 15-19 years old (60%), also had some secondary education (55%), were single (80%), and had no prior pregnancies (63%). 81% of the women who resorted to an illegal pregnancy termination were students who did not want to disrupt their education. Only 12% of illegal abortion patients and 27% of legal abortion patients had ever used a modern contraceptive method and 20% of the latter patients had discontinued method use at the time of the unplanned pregnancy. There were 4 deaths in the illegal abortion group and none in the legal abortion group. Insertion of cassava root into the cervix was the most frequently used (33%) method of illegal abortion. It is suggested that reform of the abortion law to eliminate the need for the consent of 3 doctors and to allow outpatient abortions would increase utilization of and access to legal abortion; similarly, elimination of the requirement for spousal consent would increase use of modern contraceptive methods.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094225.Article de périodique
Shapiro D.; Tambashe B.O.
The impact of women's employment and education on contraceptive use and abortion in Kinshasa, Zaire
1994 - Studies in Family Planning, 25(2), p. 96-110.
Mots clés : enquête; facteur socio-économique; éducation; activité économique; contraception; méthode contraceptive; taux; ville; résidence; étudiant; scolarisation; planning familial; facteur économique; avortement; contraception d'urgence; contraception postcoitale; population; facteur démographique
Pays / Régions : Zaïre; Afrique Centrale; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : This analysis identified urban women working in the formal sector as the primary focus for determining the relationship to fertility behavior in Kinshasa, Kenya: the effects of employment and education on contraceptive behavior and other effects on the likelihood of contraceptive use. Background information was provided on ethnic composition, family planning activity, access to schooling for women, employment patterns, fertility patterns, and contraceptive use patterns. The brief literature review identified better educated women and women employed in the modern sector as more likely to practice contraception. Weighted data were obtained from a 1990 household survey of 2399 ever sexually active women, 13-49 years old and not currently pregnant, which was stratified by socioeconomic status and residence and oversampled for the target population. Logistic regressions were used to determine contraceptive behavior. Contraceptive prevalence in the sample was just under 49.4%, of which <15% used modern methods. Rhythm and withdrawal were popular traditional methods and the condom use was the most frequently used modern method. Ever use of any method of contraception was almost 80%, and generally ever use and current use increased with educational level increases. Employees had higher lifetime prevalence than self employed or nonemployed women. Higher use was reported among women 30-44 years old. Over 15% of women reported an induced abortion, which showed slight increases with educational level increases; induced abortion reports were highly associated with high economic status. Findings from the multivariate analysis showed that increased education was significantly associated with the greater likelihood of using method of contraception. Self-employed women and employees had much higher predicted probabilities of contraceptive use. Married women were more likely to use contraception than married women who had been in more than one union, unmarried women who had been previously married, and never married women. Higher parity and desire for birth spacing were highly significantly related to contraceptive use. Recent migrants (within the past 10 years) and women enrolled in school were less likely to use contraception. Employees and women with higher economic status had a greater likelihood of reporting induced abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 095149.Article de périodique
Coffey P.S.
The psychosocial determinants of induced abortion among a rural
1994
Mots clés : enquête; focus group; enquête; déterminant; rural; résidence; psychologie; facteur psychologique; décision; avortement; contraception d'urgence; contraception postcoitale; planning familial; collecte; méthodologie; population; facteur démographique; comportement
Pays / Régions : Togo; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Eight focus group discussions involving a total of 76 women from rural Togo provided insight into the phenomenon of clandestine abortion in sub-Saharan Africa. Four groups included women under 30 years of age, while the remaining four were comprised of women aged 30-70 years. Group participants expressed unanimous support for induced abortion in cases of rape, but acceptability was equivocal in cases of unmarried status, incest, and too many closely spaced births. Failure of a fertility regulation method was not considered an acceptable reason. Support for the legalization of abortion, voiced especially by younger women, was based on avoidance of abortion-related maternal mortality and morbidity. In fact, most younger group members indicated they would terminate an unwanted pregnancy despite the religious and social opposition prevalent in their villages. Social sanctions against abortion are greater for animists than Christians, since the former requires a community ritual of retribution. Under present conditions, the pregnant woman rather than the male partner is primarily responsible for the decision to abort. Abortion is less likely, however, in situations where the male partner acknowledges paternity. Recommended, in the Togolese government's current review of its family planning policy, is greater access to modern methods of contraception and liberalization of abortion legislation.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 104754.Article de périodique
Mpangile G.S.; Leshabari M.T.; Kaaya S.F.; Kihwele D.J.
The role of male partners in teenage induced abortion in Dar es Salaam
1994
Mots clés : enquête; complication; demande; adolescence; adolescent; grossesse adolescente; grossesse; sexualité; genre; avortement; contraception d'urgence; contraception postcoitale; planning familial; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité; comportement; relation; facteur économique
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : To learn more about the role of the male partner of adolescents in Tanzania who underwent illegal abortion, interviews were conducted with 150 teenagers (mean age 17.5 years) treated at public hospitals in Dar es Salaam in December 1991-January 1992 for abortion-related complications. Upon suspecting pregnancy, 44% immediately decided to seek out abortion; none of the teenagers 17 years of age or younger even considered carrying the pregnancy to term. Males responsible for the index pregnancy fell into 3 categories: regular boyfriends (61%), causal boyfriends (23%), and men not well know to the women (10%). (It is suspected that adolescents misrepresented these responses to prevent further shame, especially younger girls who are often sexually exploited by wealthy older men.) Only 74% believed their male partner was single and 31% attributed their pregnancy to a man over 45 years of age; only 9% were impregnated by a teenaged male. For 48% of respondents, the relationship had ended by the time of the survey. 27% never informed the man responsible about the pregnancy, another 27% informed the man after confiding with others in their social network, and 46% confided first in the man responsible. Among girls who first confided in the male partner, 62% were urged to abort, 16% were encouraged to carry the pregnancy to term, and 17% were given no advice. Men informed later were more likely to be indifferent. 31% of male partners were instrumental in helping the women locate an abortionist; most of these men were steady boyfriends. On the other hand, 48% of the men responsible agreed to pay the abortionist's fee, again predominantly the boyfriends of older adolescents. Finally, only 16% of the men responsible were involved in facilitating hospital treatment for the woman's abortion-related complications. Overall, these findings suggest that males responsible for adolescent pregnancy are far more willing to provide financial support than to become involved in activities involving contact with a third party. Of concern is the sexual involvement of older men with young teenagers and the potential that these liaisons will serve as a vehicle for human immunodeficiency virus (HIV) transmission.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094224.Article de périodique
Nima J.
The situation in non-project countries
1994
Mots clés : loi; complication; adolescence; adolescent; grossesse adolescente; grossesse; programme planning familial; avortement; contraception d'urgence; contraception postcoitale; planning familial; jeune; adolescent; âge; population; facteur démographique; santé de la reproduction; fécondité
Pays / Régions : AfriqueRésumé : Reports from non-project African countries indicate an urgent need for abortion rights advocacy. Although reliable data are not available, hospital reports show that abortion contributes 20-30% of total morbidity and adolescents are the most numerous abortion complication patients. Even in countries where abortion is legal under certain conditions, illegal abortions persist due to ambiguities in the law itself or reluctance on the part of medical professionals to become involved. The preponderance of adolescent victims of illegal abortion reflects requirements for parental consent and the emphasis on the part of family planning programs on out-of-school youth. In addition, young women and poor women are forced to seek out clandestine, untrained providers given the prohibitive cost of legal abortion. Prevention of further illegal abortions is stymied by a lack of linkage between abortion providers and family planning programs. A major obstacle is the lack of awareness on the part of policy makers, community leaders, and the medical profession of the scope of the problem of illegal abortion and its costs in terms of both human lives and the diversion of scarce medical resources.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094227.Article de périodique
Ramalefo C.; Modisaotsile I.M.
The state of unsafe abortion in Botswana: evidence from proxy indicators. Draft
1994
Mots clés : complication; loi; demande; grossesse adolescente; grossesse; adolescence; adolescent; mortalité maternelle; offre contraception; avortement; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; jeune; adolescent; âge; mortalité; contraception; méthode contraceptive; facteur économique
Pays / Régions : Botswana; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Although Botswana's abortion law was liberalized in 1991 to permit the procedure in cases where the pregnancy is a result of rape/incest or could endanger the woman's health, it forces the majority of abortion seekers--women who want to abort for social or financial reasons--to obtain an illegal pregnancy termination. No comprehensive studies have evaluated the magnitude of abortion in Botswana; however, 4 proxy indicators--unmet need for family planning, adolescent pregnancy, maternal morbidity, and maternal mortality--attest unsafe abortion is a common social problem. The 1991 Demographic Health Survey found that 45% of women in Botswana who wanted to control their fertility did not have contact with a family planning program. This large unmet need for contraception suggests massive numbers of unwanted pregnancies. There has been an especially rapid increase in teenage parenthood (in 1988, 24% of females 15-19 years old were mothers). Evidence that many teenagers attempt to terminate unwanted pregnancies rather than carry them to term is provided by statistics compiled from the country's hospitals; 43% of the 3731 treated in 1992 for complications of illegal abortion were under 25 years of age. Hospital personnel concur that unsafe abortion represents a major health problem and accounts for at least 14% of total maternal mortality. The long-term goal should be legalization of abortion on demand. In the interim, abortion rights proponents are urged to compile more statistics on illegal abortion, identify population subgroups that are not using family planning and the obstacles to such use, upgrade the counseling skills of health workers, and target IEC programs to youth.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094221.Chapitre d'ouvrage
Leke R.J.; Chikamata D.M.
The tragedy of induced abortion in sub-Saharan Africa
1994 - In B.T. Nasah,M.J. K.G., et K.J. M. (Eds.), Contemporary issues en maternal health care in Africa, p. 281-292. Harwood academic publishers
Mots clés : complication; loi; service de santé; contraception d'urgence; contraception postcoitale; planning familial; soin de santé primaire; soin; santé
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : This book chapter presents a discussion of induced abortion in Africa as a major cause of maternal morbidity and mortality. The authors offer strategies for preventing abortion and treating abortion complications. Abortion may be grouped according to type: threatened, inevitable, incomplete, complete, missed, repetitive, and septic. Spontaneous abortion may affect 10-15% of all pregnancies, and it is generally due to fetal abnormality. Almost all of maternal mortality occurs in developing countries. The incidence of unsafe induced abortion is considered to be very high. The true incidence in Africa is difficult to determine. Immediate complications of induced abortion include hemorrhage, perforations of the uterus and genital organs, burns and lacerations of the vagina and cervix, vesico-fistulas, and shock. Late complications include pelvic inflammatory disease, secondary infertility, dysmenorrhea, and social and psychological problems. The prevalence of induced abortion in Africa may be reduced by the following measures: educating youths about the dangers of adolescent pregnancy, providing sex education, eliminating traditional practices that negatively affect the health of the mother, offering counseling, providing access to health services, providing social support and welfare for mothers, involving youths in all programs to avoid unwanted pregnancies, using the risk approach of referral to the appropriate health care level, and reinforcing the practice of safe abortion. Many African countries still have old laws restricting abortion. Access to a safe legal abortion will require legal changes, wider availability of information, and reduced bureaucratic requirements. Abortion complications need to be managed better.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 123043.Article de périodique
Anderson B.A.; Katus K.; Puur A.; Sylver B.D.
The validity of survey responses on abortion : evidence from Estonia
1994 - Demography, 31(1), p. 115-132Résumé : The aim of the study was to make individual-level comparisons of the completeness and accuracy of reporting on abortion in Estonia, by comparing respondents answers with the medical records. The specific objectives were to assess the general level of underreporting of abortion, and to relate responses to demographic characteristics: age, education, marital status, ethnic affiliation, and reproductive history. Other measurable factors were where the interview occurred and whether someone else was present, residence with parents, and the approval of husband toward the abortion. The sample was 264 women registered for elective abortion in maternity hospital in Tallinn, Estonia in 1991. The survey was conducted between April and May, 1992, among 264 women. There were an additional 40 women who were used as controls. Control data was not included in the analysis. Abortion is legal in Estonia, widely used, and not highly stigmatized. The questionnaire was carefully constructed in the ordering of questions: the abortion questions were placed in the third block of questions after social questions and health status and before health care use. Although miniabortions have been available since 1986, the survey women all had hospital abortions. The results showed that 93% of respondents reported having at least one abortion, of which 85% reported it as an abortion, 7% as a miniabortion, 8% as a miscarriage and 1% as a stillbirth. 74% reported the abortion occurrence was in 1991 or 1992; the stricter the test of response validity the greater the underreporting, although still less than found in American surveys. Estonians were less likely to report abortions than Russians: 74% versus 84%, which may reflect awareness of contraceptive failure among Estonians. Older women, who do not have as many abortions, women with 3 or more children, and women with late abortions were less likely to report abortions. The descriptive results were confirmed in the logit analysis. Women with 3 or more children and older women also reported more miscarriages. The only interview context measure of importance was unmarried women living with parents; these women were less likely to report an abortion. 12% of respondents' aggregate lifetime abortions were estimated as not reported. Children ever born data was accurate.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 093792.Congrès
Anonymous
Unsafe abortion and post-abortion family planning in Africa. The Mauritius conference
1994 - Unsafe abortion and post-abortion family planning in Africa. The Mauritius conference, Mauritius, 36 p p.
Mots clés : complication; loi; soin post-abortum; programme planning familial; complication grossesse; maladie; complication; avortement; contraception d'urgence; contraception postcoitale; planning familial; facteur économique
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : In March 1994, more than 100 specialists from family planning associations (FPAs) and ministries of health participated in the IPPF-supported Conference on Unsafe Abortion and Post-Abortion Family Planning in Africa (sub-Saharan Africa) in Gran' Baie, Mauritius. It was designed to help FPAs and governments confront the public health and social problems caused by unsafe abortion. Topics discussed in the working groups were abortion and postabortion family planning services, role of support services in abortion and postabortion family planning services, counseling and contraceptive needs, and reducing the number of unsafe abortions. Working groups developed strategies and action plans to reduce the incidence of unsafe abortion in Africa. The estimated unsafe abortion rate in Africa is 23/1000 women aged 15-49, ranging from 12 in Middle Africa to 31 in Eastern Africa. In Nigeria, 50% of all maternal deaths are related to abortion. In Kenya, insertion of foreign bodies/instruments is the most common abortion method. In Benin, most abortion patients are married (70.5%) and Catholic (58.7%). No African country provides abortion on demand. Botswana, Ghana, and Zambia have the most liberal abortion laws (abortion allowed for social and sociomedical reasons). In countries where abortion services are legal, FPAs can produce a list of sympathetic health personnel, conduct a follow-up on women who have been denied safe abortion services, document where safe abortion services are withheld from some population groups, promote the use of newer abortion techniques, and provide training in safe abortion techniques. Many donor and technical cooperating agencies have made commitments and implemented initiatives to bring about safe abortion and postabortion family planning services in Africa, such as Family Health International and Johns Hopkins University's Center for Communication Programs.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 100699.Article de périodique
Mbizvo M.T.
Unsafe abortions and unwanted pregnancy contribute to maternal mortality in Zimbabwe
1994
Mots clés : complication; grossesse non prévue; grossesse non désirée; mortalité maternelle; programme planning familial; programme; demande; complication grossesse; maladie; complication; santé de la reproduction; fécondité; population; facteur démographique; mortalité; planning familial; facteur économique
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : During a 2-year period (1989-90), a community-based incident case-referent study was conducted in a rural and an urban location in Zimbabwe in order to improve estimation of the maternal mortality rate and to investigate the associated causes, risk factors, and preventable factors. This paper reveals the contribution of induced abortion and unwanted pregnancy to overall maternal mortality. 30 abortion-related deaths were identified (24.7 and 18.1 per 100,000 live births in the rural and urban area, respectively), making abortion the second leading cause of maternal death. An additional 4 women committed suicide because of an unwanted pregnancy. Most of the women who underwent abortion were single and self-supporting. Most delayed seeking care, and they often hid their abortion history. The care these women received was also deficient in many cases, with deaths occurring from preventable factors such as lack of transport for referrals and failure to recognize the severity of the condition. A comparison of abortion cases with women who delivered during the same period revealed a high rate of unwanted pregnancy in both groups. Many of the referent cases reported attempts to induce abortion. It is recommended that family planning services be made accessible to unmarried women and that women be allowed to receive legal termination of pregnancy from the formal health care system.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 108272.Article de périodique
Otsea K.; Benson J.
Using self-assessment tools to improve abortion care in Africa
1994
Pays / Régions : TanzanieRésumé : Approximately 150,000 women, mostly in the developing countries, die from complications of unsafe abortions, many of which deaths could have been prevented. IPAS, an international nonprofit organization, is dedicated to improving women's reproductive health in over 16 countries by means of training providers in manual vacuum aspiration (MVA) for incomplete abortions. In mid-1992 the Department of Obstetrics and Gynecology at Muhimbili Medical Center in Dar es Salaam, Tanzania, started collaborating with IPAS to treat incomplete abortions at Muhimbili and 3 district hospitals in Dar es Salaam. Staff obstetrician-gynecologists, residents, and interns were trained in the use of MVA, and nurses were trained in appropriate infection prevention and patient management. MVA services were later established at 4 sites to ease the stress on operating theaters. IPAS undertook the development of a self-guided assessment technique to help providers appraise the overall quality of their services. Other assessment models were also utilized: the Association of Voluntary Surgical Contraception's COPE process and the Primary Health Care management modules developed by the Aga Khan Health Network and PRICOR. The assessment technique was pilot tested through written assessment tools and 2 interactive workshops. Within the framework of written assessment an assessment workbook was provided to doctors and nurses from each of the 7 sites where postabortion care programs were implemented. Workshop no. 1 conducted in March 1994 involved the doctor-nurse teams from the 7 MVA sites to carry out group discussions to analyze key problems of abortion care services. Critical problems to be improved at these sites included training more nurses and providing postabortion family planning counseling. Workshop no. 2, conducted in August 1994, contained a special session on postabortion family planning and evaluation of the assessment process itself. Emphasis was placed on counseling postabortion patients by identifying difficulties that resulted in the unwanted pregnancy.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101573.Rapport
Shapiro D.; Tambashe B.O.
Women's employment, education, contraception and abortion in Kinshasa
1994 - University Park, Pennsylvania, Population Research Institute, Pennsylvania, 45
Mots clés : enquête; contraception; méthode contraceptive; déterminant; ville; résidence; activité économique; éducation; religion; âge; planning familial; contraception d'urgence; contraception postcoitale; population; facteur démographique; facteur économique; facteur socio-économique
Pays / Régions : Kenya; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The research aim was to examine the effects of employment, education, and other factors on contraceptive use and incidence of abortion among urban women in Kinshasa, Zaire. Kinshasa has an estimated 10% of Zaire's total population, and 40% of the women work; major demographic groups are the Bakongo- and Kikongo-speaking populations. Fertility in Kinshasa tends to be higher than for Zaire as a whole. Three independent organizations provide family planning services in Kinshasa, but level of use was considered low, based on a situation analysis, and primarily for birth spacing. The 1991 Contraceptive Prevalence Survey cited abortion as the most widely used method. Data were obtained from a 1990 household survey of 2400 women, aged 13-49 years, for the descriptive and weighted logistic regression. Variables included completed education level, employment status, age, enrollment status, economic status, marital status, fertility, desire for another child, migration status, religion, and ethnic group. The results showed that the determinants of contraceptive behavior of ever sexually active women, not currently pregnant, were increased schooling and employment status as self employed or employees. Other significant factors were age and high economic status. Contraceptive use was less likely among married women who have been in more than one union than among those in first unions. Among previously but not currently married women and never married women, contraceptive use was less likely. Greater contraceptive use was related to higher parity. Contraceptive use was less likely among women who migrated within the past 10 years than among nonmigrants, but the differences disappear with increasing age. NonCatholic groups have greater likelihood of contraceptive use. The likelihood of modern contraceptive use increased with levels of schooling beyond the primary level. Use increased with age up the age of 39 years. Determinants of abortion were educational attainment; women with higher educational levels, self employment, and higher economic status showed greater likelihood of reporting abortion. Migrants were less likely to report an abortion. Kimbanquists and those without religion were more likely, and Protestants and other religions were less likely to report an abortion compared to Catholics.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 093327.Article de périodique
Anonymous
Women, families and the future. Women and reproductive health in Sub-Saharan Africa
1994
Mots clés : santé de la reproduction; taille famille; prévalence contraceptive; demande; grossesse non prévue; grossesse non désirée; loi; espacement naissance; santé; famille; contraception; méthode contraceptive; planning familial; facteur économique; fécondité; population; facteur démographique; avortement; contraception d'urgence; contraception postcoitale
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : In sub-Saharan Africa, high infant mortality rates and women's lack of access to education and economic opportunity have contributed to a persistence of high fertility (an average of 6-7 children). Moreover, the gap between desired family size and actual family size observed in developing countries in Latin America does not yet exist, limiting motivation for family planning services. When questioned about future childbearing, about one-third of married women report they want no more children and half do not want another child soon. This finding suggests a need for interventions that enable women to extend the interval between births. In 10 of the 16 countries in sub-Saharan Africa, less than 16% of currently married women are contraceptive users. There are only 4 countries--Botswana, Kenya, Namibia, and Zimbabwe--where use of modern methods of contraception exceeds 7%. Overall, at least 30% of women in the region, or 37 million women, are in the need of family planning or a more effective method, largely for birth spacing purposes. Aggregation of survey data suggests that 76% of births in the region are wanted, 10% are mistimed, 3% are unwanted, and 11% are terminated by illegal abortion. Program and policy interventions aimed at giving women in sub-Saharan Africa greater control over the timing of their pregnancies and family size must be multifaceted, aimed at improved health and survival, educational and economic opportunities for women, and more available primary health care. Also needed are educational and mass media campaigns that explain the benefits of modern contraception and correct misinformation about side effects.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 098139.Graphique/Tableau
United Nations; Population Division
World abortion policies 1994
1994 - United Nations,
Source : source : United Nations.
1992Article de périodique
Ampofo D.A.; Collison A.H.; Richardson D.; Kwofie G.; Senah K.A.
"Contraceptives cause infertility". Determinants of decision-making factors in women with knowledge of contraception who resort to induced abortion
1993
Mots clés : méthodologie; enquête; décision; contraception; méthode contraceptive; avortement; programme planning familial; étudiant; scolarisation; comportement; planning familial; contraception d'urgence; contraception postcoitale; service de santé; soin; santé
Pays / Régions : Ghana; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Family planning devices and services have been available to Ghanaians since 1969; however, the demand for abortion by women has not reduced in any appreciable terms. It is even noted that the legalization of abortion in 1985 as a way of making abortion safe has rather fuelled the demand for abortion. In this exploratory, cross-sectional, comparative and descriptive study, determinants of decision-making factors in Ghanaian women with knowledge of contraception but who resort to induced abortion are examined. Data from 900 women drawn from both the urban and rural areas around Accra, Tema and Nsawam were analyzed. Overall, it has been found that among both urban and rural women, knowledge of the family planning concept, as well as induced abortion is very high. However, use-rate of contraceptives is very low and a very high percentage of respondents have had an abortion at least, on two occasions. Observations indicate that women resort to induced abortion primarily when from their own assessment a pregnancy is a roadblock to their status aspirations. This is reinforced by the belief that most of the modern contraceptive devices cause infertility and other health problems while induced abortion, if performed by a qualified doctor does not pose such dangers.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 139540.Article de périodique
Bradley J.; Rogo K.O.; Johnson R.; Okoko L.; Healy J.; Benson J.
A comparison of the costs of manual vacuum aspiration (MVA) and evacuation and curettage (E and C) in the treatment of early incomplete abortions in Kenya
1993 - Journal of Obstetrics and Gynaecology of Eastern and Central Africa, 11(12-19
Mots clés : méthodologie; enquête; analyse; échec; coût; traitement; soin; étudiant; scolarisation; avortement; contraception d'urgence; contraception postcoitale; planning familial; intervention chirurgicale; méthode; intervention chirurgicale
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Limited access to safe abortion is a leading cause of maternal mortality and morbidity in the developing world. Hospitals are often overwhelmed by the large number of women presenting for treatment of the complications of previous unsafe abortions. In many settings, the number of incomplete or septic abortions comprises more than half of all gynecological admissions. In the absence of measures to reduce the incidence of unsafe abortions, hospitals treat these female patients with complications in the most efficient and effective manner allowed by limited available resources. In most developing countries, Evacuation and Curettage (EC) is the standard approach to treating cases of incomplete abortion. Requiring a physician, operating theater, and often general anesthesia, EC is usually performed in the hospital setting. Patients may have to wait several days for treatment, a period during which complications such as hemorrhage and sepsis may develop. In the developed world, however, Manual Vacuum Aspiration (MVA) is the standard treatment for uterine evacuation. MVA usually requires neither anesthesia, anesthetist, operating theater, nor an overnight stay, and it may be performed by a wide range of trained medical personnel including physician's assistants, nurse practitioners, and nurse midwives who may work in rural health clinics with no operating room facilities. This paper documents the magnitude of differences in cost between MVA and EC in the treatment of early incomplete abortions in the following four hospitals in Kenya: Kenyatta National Hospital in Nairobi, Kisii District Hospital, Eldoret District Hospital, and Machakos District Hospital. Data were collected over the period March-June 1991 and consider costs comprehensively in terms of staff time, in-patient or hotel costs, and drugs and equipment. Analysis found MVA to be the most appropriate and cost-effective way of managing incomplete abortion. Effort should therefore be made to extend the availability of MVA to all district hospitals and to effect changes in patient management which can maximize the benefits of MVA and the use of available resources.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 103854.Article de périodique
Cope J.
A matter of choice: abortion law reform in apartheid South Africa
1993
Mots clés : politique; programme
Pays / Régions : Afrique du SudRésumé : This account documents the role and struggles of the Abortion Reform Action Group (ARAG) in trying to pressure the South African government to pass legislation allowing legal abortion during the first trimester. The author's thesis is that the government, led by the National Party, followed an agenda of lies and deceit to keep abortion from becoming legal in the White, Afrikaaner regions (a pronatalist policy) while allowing Blacks to die from unsafe abortion in the independent homelands (an antinatalist policy), thus effectively subsuming the abortion issue into overall apartheid policies. Following 2 chapters of background material on abortion law and reform efforts in South Africa and other countries (especially Britain), the book covers the abortion rights struggle in apartheid South Africa from 1972 until the present. The major actors in this struggle were: June Cope, founder of ARAG; Dolly Maister, founder of the Cape Town-based South African Abortion Reform League, which later became part of ARAG-National; Helen Suzman, the Minister of Parliament who voiced the concerns of ARAG and fought for abortion law reform; and numerous governmental officers. The law that was finally passed, the Abortion and Sterilization Act of 1975, was very restrictive; abortion is only legal if the life of the woman is in danger; the woman will suffer permanent mental damage, which must be assessed by a state-employed psychiatrist; in cases of proven fetal abnormalities; or in cases of rape or incest. Even if these conditions are met, the woman must obtain certificates from 2 doctors before receiving treatment from a third, unrelated doctor. Cope claims that now that apartheid is being dismantled, this 1975 law, which was based upon apartheid policies, should be reformed as well.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101418.Article de périodique
Huntington D.; Mensch B.S.; Toubia N.
A new approach to eliciting information about induced abortion
1993 - Studies in Family Planning, 24(2), p. 120-124.
Mots clés : avortement; enquête; contraception d'urgence; contraception postcoitale; planning familial; analyse; méthodologie; service de santé; soin; santé; éthique
Pays / Régions : Cote d'Ivoire; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Considerable underreporting occurs in survey data based on the respondent's declaration about an induced abortion. The World Fertility Surveys were the main instrument for assessing the incidence of induced abortion. Revised Demographic and Health Surveys asked about "induced abortions, miscarriages, and stillbirth," but did not separate out abortion. In the Ivory Coast, experimental data were collected on induced abortion as part of an operations research study of quality of care in family planning (FP) clinics. The questions asked are considered applicable to any population-based or facility-based survey. A brief summary of FP in the Ivory Coast is provided. Situation analysis methodology was used in the 9-month study which took place between February, 1992 and April, 1993. Interviews were conducted with service delivery point staff and new acceptors before and after their FP consultations. The approach used for the abortion questions was to emphasize unwantedness and to ask what community women might think about abortion. Pretesting confirmed that interviews would elicit frank responses when conducted in a confidential and value-free manner. 44% (152 women) reported a history of unwanted pregnancy, of which 59% stated that the pregnancy was terminated. Another 6% indicated having attempted an abortion. Failure to responses was <1%. In the exit interviews, 25% of FP clients reported a history of abortion (90 out of 347 women). 3% reported unsuccessful attempts to self-abort. A significant number of younger women had a successful abortion as compared to women who took other actions. 2% became pregnant while using a FP method. The reasons reported for not wanting a pregnancy were husband's or partner's objection (35%), economic constraints (16%), and social unacceptability as in the case of a single or young woman (16%). 75% of the clinic staff reported that there were client requests for advice on abortion. Clinic staff (46 persons) provided 106 different responses to the question about acceptable reasons for abortion. The most common responses were maternal health reasons (31%), saving a woman's life (27%), and risk to fetal health or fetal handicap (22%).
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 082663.Article de périodique
Madebo T.; T G.T.
A six month prospective study on different aspects of abortion
1993 - Ethiopian Medical Journal, 31(3), p. 165-172
Mots clés : enquête; complication; avortement spontané; fausse couche; demande; mortalité maternelle; santé de la reproduction; contraception; méthode contraceptive; avortement; contraception d'urgence; contraception postcoitale; planning familial; étudiant; scolarisation; méthodologie; complication grossesse; maladie; complication; mortalité; population; facteur démographique; santé
Pays / Régions : Ethiopie; Afrique de l'Est; Afrique Subsaharienne; AfriqueRésumé : In a 6-month prospective study conducted at Sidamo Regional Hospital (Yirgalem, Ethiopia) from April 1 to September 30, 1991, 185 cases of abortion were admitted. 64 (35%) of these abortions were illegally induced and 121 (65%) were spontaneous. During the study period, there were 443 gynecological admissions; thus, illegal abortion comprised 14% of total cases treated. There were 2 deaths in the induced abortion group (0.8% case fatality). 50 (78%) women with illegal abortions were under 25 years of age and 42 (66%) were unmarried. Instruments most often used to induce abortion were plastic catheters (56%) and metallic objects (32%); the procedure was performed by health workers in 55% of cases and friends in 39%. 122 (66%) of women admitted with induced abortion required evacuation and curettage. Complications of illegal abortion included septicemia (36 cases), hemorrhagic shock (12 cases), pelvic abscess (11 cases), and cervical trauma (22 cases). The mean hospital stay for induced abortion was 6.3 days compared with 2.1 days for spontaneous abortion. 83% of women in the induced abortion group were using no form of contraception prior to the unwanted pregnancy, 11% were using a method incorrectly, and 6% were considered to be proper users. Since 41% of women in the spontaneous abortion group reported that their pregnancy was unwanted, it is possible that some may have in fact undergone an illegal abortion. Unable to be measured were the long-term effects of illegal abortion, including chronic pelvic inflammatory disease and infertility. Overall, these findings document the magnitude of the problem of illegal abortion in Ethiopia and indicate an urgent need for contraceptive education among young women.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 095183.Article de périodique
Yoseph S.
A survey of illegal abortion in Addis Ababa, Ethiopia
1993
Mots clés : planning familial
Pays / Régions : EthiopieRésumé : This cross-sectional study assessed the extent of the problem of illegal abortion in all 5 government-run hospitals with gynecological services in Addis Ababa, Ethiopia, and determined the risks and costs incurred in treating cases. The specific objectives were to 1) measure the incidence of spontaneous and induced abortion in Addis Ababa; 2) measure morbidity and mortality resulting from induced abortion in the study hospitals; 3) characterize women with induced abortion; and 4) estimate the medical and economic resources spent on treatment of abortion complications. Trained nurses collected data using a structured questionnaire. The study population of all women admitted with a diagnosis of abortion or its complications between August 20, 1990 and February 20, 1991 was categorized as: certainly induced, probably induced, possibly induced, or spontaneous. During the study period, 2275 abortion cases were treated, out of which 2015 (88.6%) were from Addis Ababa; women who were admitted with diagnosis of abortion, with or without complications, and who resided outside of Addis Ababa were included in the study but were not considered for estimating the incidence of abortion. There were 7158 deliveries in the hospitals; thus, the incidence of all abortions to deliveries was 281.5/1000, and the incidence of induced abortion to deliveries was 200/1000. 1290 (56.7%) abortion patients admitted to interfering with the pregnancy. In 78% and 69.2% of all cases, the current pregnancy was unplanned and unwanted, respectively; however, 44.5% of all patients had never used family planning methods, although 84.1% were aware of their availability. Almost 90% of the induced abortion patients were between the age of 15-30 years, 46.8% were nulliparous, 55.6% were single, 60.2% had incomplete or complete secondary education, and 27.9% were students. Therefore, the likelihood of having induced abortion increases if the woman is young, urban, educated, unemployed, and single. In the certainly induced abortion cases, interference was attempted most often at 9-12 weeks gestation (37.4%). The most common method used to elicit abortion was insertion of a foreign object into the uterus. Abortions were most often performed by health assistants (35.3%) or by the women themselves (28.4%); doctors were the abortionists in only 7.3% of the cases. Although 83.6% of all abortion cases stated they "did not want to have a child now," only 17.4% stated that they did not want any more children, indicating that the women are using induced abortion as a method of child spacing. The induced abortion patients had significantly longer hospital stays (2.96 days) than the spontaneous abortion patients (1.96 days). The authors concluded that illegal abortion significantly contributes to maternal morbidity and mortality in Addis Ababa and must be adequately addressed as part of any reproductive health plan. Detailed policy recommendations included: providing family life education; making contraception accessible to all women, especially adolescents; providing pre- and postabortion counseling; implementing public education about the impact of societal changes on the sexuality of adolescents; legalizing abortion; and improving the health care delivery system.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101368.Article de périodique
Anonymous
Abortion and HIV-positive women in Sub-Saharan Africa
1993 - Reproductive Health Matters, 2), p. 130
Mots clés : VIH; avortement; infection; complication; maladie; maladie; complication; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Zambie; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Abortion is illegal except on strict therapeutic grounds in many countries of sub-Saharan Africa. Being seropositive for HIV and/or having AIDS may, however, be considered grounds for a legal abortion. No documented information has been made available on whether and how often women in these circumstances ask for abortions and whether hospitals or other clinics provide or refuse to perform them when requested. Gynecologists in 3 sub-Saharan African countries reported, however, that clinics in their hospitals regularly provide abortions to HIV-seropositive women upon demand, but refused to give any details which might identify them for fear of retribution and public controversy over the services. In Zambia, abortion is allowed if certified by 3 physicians and if the woman's health is threatened. Cases of septicemia have been reported in the country among women subjected to unsafe abortion procedures from traditional and private practitioners; the majority of HIV-positive women who get abortions also become infected. It is therefore the norm to give a broad-spectrum antibiotic for 7 days to women undergoing abortions. Further, since 75% of HIV-positive women having had caesarean sections have had delayed wound healing, both Caesarean sections and laparotomy are avoided as much as possible; both procedures increase their risk of infection.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Ogedengbe O.K.
Abortion care using manual vacuum aspiration: the cases of Nigeria, Zambia, Kenya and Zimbabwe
1993 - 28-31Résumé : Unsafe abortion is a major cause of maternal mortality and disability in the developing world. International Programs Assistance Services (IPAS) has trained health providers in uterine evacuation procedures at teaching hospitals in a number of African countries since 1987. This paper reviews the progress of the programs, with particular reference to Nigeria where approximately 575 public and private health care providers in 10 states have been trained in manual vacuum aspiration. A recent meeting of facilitators in Kaduna, Nigeria, found the procedure is being performed less expensively and more effectively, with less waiting time, than traditional methods of evacuation. As the acceptance of manual vacuum aspiration and appropriate training grow, the degree of maternal mortality from abortion-related complications in developing countries should decrease substantially.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 116791.Article de périodique
Ebijuwa T.
Abortion, women and national development: the Nigeria experience
1993 - Ahfad Journal, 10(1), p. 33-43
Mots clés : avortement; grossesse non prévue; grossesse non désirée; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The author argues that, if women have the right of self-determination, it is immoral of society to withhold or limit women's access to abortion services in Nigeria. Morality must pertain to society as well as women. In Nigeria, the abortion argument tends to focus on the rights of the fetus or the third party's interest. The abortion issue must involve understanding the rationale that is used by abortion-seeking women. Denial of access to abortion services dehumanizes women and reduces growth in national development. Women carry the burden of responsibility associated with child bearing and rearing. Unwanted pregnancies impose severe psychological, physical, social, and medical dangers on women. Impaired psychological and physical illness creates pain and suffering and limits productivity. "Doing good" is not necessarily accomplished by either abortion or unwanted childbearing. Society both discourages the taking of a human life and supports the health of its citizens, many of whom are women. A child brought into this world who is not adequately taken care of will be a burden to society. When society pursues its own self-interest in preventing abortion as a choice for women, then society becomes immoral and selfish. A woman pursuing her own self-interest is not necessarily immoral. The decision becomes immoral if the woman acts against the wishes of the father. Morality is not necessarily the opposite of the promotion of one's self-interest. Women who seek to terminate a pregnancy for health reasons seek a virtuous option of enhancing the well-being of every individual in society. The right to life for the fetus is very different from the right to self-determination for the abortion-seeking woman. When the Yoruba define a wife as a servant to the husband, the Yoruba deny women personhood. Women know best what serves their self-interest and that of society.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 126423.Article de périodique
Likwa R.N.
Abortion: "a risk factor to maternal mortality in East, Central and Southern Africa (ECSA)"
1993
Mots clés : enquête; avortement; complication; mortalité maternelle; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; mortalité; population; facteur démographique
Pays / Régions : Afrique Subsaharienne; Lesotho; Malawi; Ouganda; Zambie; Afrique; Afrique Australe; Afrique Anglophone; Afrique de l'EstRésumé : Because the incidence of maternal mortality in Africa is estimated at more than 600 deaths/100,000 births, a case-control study was undertaken to determine the factors associated with maternal mortality in Lesotho, Malawi, Uganda, and Zambia. The specific objectives of the study were to determine the association of maternal mortality with demographic and socioeconomic factors as well as with health service and environmental factors. The 288 cases were women who died as a result of complications of pregnancy and childbirth. The 864 controls were women who were admitted to the same institutions because of pregnancy and childbirth who did not die. Information was also gathered on 859 control proxies. Out of the 288 deaths, 81 (30%) were due to abortion. The 3-year study took place from 1990 to 1992. Data were collected from interviews with close relatives of the cases and from interviews with the controls. Single women aged 25-29 years with parity of 1-2 were at a higher risk than other women of maternal death due to abortion complications. Most of the abortion patients who died induced the abortion themselves or used traditional medicines. To alleviate some of the problems associated with unsafe abortion, it was recommended that appropriate abortion services be provided, that information be disseminated about the risks of abortion, that indications for legal abortion be more broadly interpreted and that legal constraints be removed, that family planning programs be strengthened, that girls be encouraged to remain in school, and that further research be conducted.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 104012.Article de périodique
Kuyoh M.A.; Magadi M.A.
Abortion: attitudes of medical personnel in Nairobi, Kenya
1993 - 39
Mots clés : avortement; personnel de santé; attitude; soin post-abortum; contraception d'urgence; contraception postcoitale; planning familial; soin; santé; psychologie; facteur psychologique; comportement; programme planning familial
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Abortion can present a difficult personal, ethical, and moral predicament for physicians and paramedical personnel. The objectives of this study were to establish the attitudes of physicians, clinical officers, and nurses toward induced abortion; to examine the effect of selected social, cultural, economic, and demographic characteristics on these attitudes; and to determine medical staff's opinions about postabortion counseling. A sample of 105 doctors, 29 clinical officers, and 137 nurses responded to structured, self-administered questionnaires given out to a stratified random sample of 200 doctors, 36 clinical officers, and 200 nurses (resulting in a response rate of 62%). The doctors were sampled from a list of all registered medical doctors at the Directorate of Medical Services in the Ministry of Health, stratified by specialty. A sample of clinical officers and nurses currently working in maternal and child health clinics, maternity wards, and pediatric sections of 30 health institutions in Nairobi was also drawn. 62% of respondents had handled or come across abortion patients in their day-to-day activities, while 56% had been confronted by a close friend or relative seeking abortion. No medical personnel admitted terminating a pregnancy themselves. They were, instead, against liberalization of abortion law in Kenya. Doctors had a more liberal attitude toward abortion than clinical officers or nurses. Age, marital status, religion, specialty, and number of children influenced the respondents' attitudes toward abortion. Postabortion counseling that addressed the dangers of repeated abortion and encouraged contraceptive use was acceptable to 95% of the respondents. (full text)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 116795.Article de périodique
Oniango R.K.
Adolescent fertility: "Who chooses abortion"? Final report
1993
Mots clés : méthodologie; adolescence; adolescent; fécondité; avortement; grossesse non prévue; grossesse non désirée; décision; jeune; adolescent; âge; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; comportement
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This final report presents the findings of the research which ascertained the decision-making process involved in choosing abortion and determined specific informational needs that are not being met. The study mainly focused on circumstances surrounding and leading to abortion as an option in dealing with an unwanted pregnancy. A total of 77 young Kenyan women who had or were at the time of the study expectant were identified as key respondents. In summary, factors encouraging or discouraging abortion include initial acceptance or non-acceptance by the "father", family support or lack of support, and financial stability of the young woman's family. In addition, lack of knowledge about their bodies and contraception has increased the number of abortions as the only option. It is noted that teachers are the most appropriate community members to share information with young adults on their bodies, contraception, and pregnancy. In view of the findings, it is recommended that a package of combined interventions need to be developed for use by teachers, parents, community leaders and young adults themselves.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 135295.Article de périodique
Pillai V.K.; Achola P.P.; Barton T.
Adolescents and family planning. The case of Zambia
1993 - Population Review, 37(1-2), p. 11-20
Mots clés : enquête; grossesse adolescente; grossesse; fécondité; sexualité premaritale; programme planning familial; programme; prévalence contraceptive; avortement; incidence; complication grossesse; média; adolescence; adolescent; soin; étudiant; scolarisation; méthodologie; santé de la reproduction; population; facteur démographique; sexualité; comportement; planning familial; contraception; méthode contraceptive; contraception d'urgence; contraception postcoitale; mesure; maladie; complication; communication; jeune; adolescent; âge; santé
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Newspapers headlines in Zambia have focused on adolescent pregnancy, illegal teenage abortions, child dumping and prostitution. The population at risk are sexually active and pregnant as well as teenage mothers teenagers. News accounts have mentioned a decline in the prevalence of initiation ceremonies, a devaluation of family life, ignorance of sex, sexual permissiveness, and the need of adolescents for attention. Sexual activity among adolescents has been reported in surveys as 27.3%. Surveys of women of the reproductive age show that 63% do not know of any birth control methods. Teenage knowledge is likely to be higher. Zambia required certification by 3 medical practitioners that an abortion is needed to protect the health of the mother. Surveys reveal that many unmarried women 18-24 years have had legal abortions. Miscarriages were reportedly high for 15-19 year olds (at least 10%). Sexually transmitted disease rates were high among sexually active 10-14 year olds (almost 10%) and among 18-21 year olds (almost 25%). The social consequences of teenage sexual activity (social disgrace) vary among families and ethnic groups, depending on the norms for virginity. Early childbearing also has undesirable consequences and experiences: anemia, toxemia, fetal mortality, increased obstetrical risk, low birth weight babies and a faster paced future fertility. Teenage mothers may suffer discrimination and los of occupational and educational prospects. Options for the provision of welfare services for teenagers are to provide health, and sex education and family planning (FP) services through social services or to rely on and train the family to instruct and support teenagers. Other models are to program train students and use them in a peer approach to information dissemination and emotional support. Services for pregnant teenagers are usually directed to problems involving medical complications, psychological consequences, and social maladjustments. FP in Zambia should emphasize the important role of family and peers and revive initiation ceremonies for females. Contraceptive distribution should not be restricted; contraceptives must be easily available for teenagers, and legal abortion must be permitted.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 090121.Article de périodique
Maforah F.
Attitudes of the community towards therapeutic abortion
1993 - 39
Mots clés : avortement; attitude; communauté; anti-avortement; contraception d'urgence; contraception postcoitale; planning familial; psychologie; facteur psychologique; comportement; résidence; population; facteur géographique; facteur politique
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Maternal mortality has been identified as a major cause of death for women aged 25-34 years in developing countries. Because of the lack of available services, both for family planning and termination of unwanted pregnancy, improperly performed abortions cause a substantial component of this mortality. A high percentage of reproductive-aged women live under restrictive abortion laws. Therefore, this study was conducted in South Africa to determine the attitudes of the community regarding "therapeutic abortion" (which is presently the only condition under which abortion is legally permissible). A descriptive survey method was employed to draw a representative sample from the three areas of Bophuthatswana--urban, peri-urban, and rural. A sample of 562 households was selected according to the principles of stratified random sampling, and the adult male or female from each household was interviewed. A semi-structured interview schedule was used for this purpose. The findings revealed that people, regardless of educational qualifications or religious affiliation, were conservative and not psychologically prepared to accept or implement medically-indicated abortion procedures. The respondents' strong opposition to therapeutic abortion was linked to their perceptions of the benefits and potential empowerment that could result from such a procedure. Recommendations are made for NGOs and researchers involved in women's issues to increase the awareness of communities, particularly women in this regard. (full text)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 116794.Article de périodique
Johnson B.R.; Benson J.; Bradley J.; Rabago Ordonez A.
Costs and resource utilization for the treatment of incomplete abortion in Kenya and Mexico
1993 - Social Science Medicine, 36(11), p. 1443-1453.
Mots clés : complication; facteur économique; intervention chirurgicale; adulte; âge; enquête; dilatation curetage; méthode; femme; homme; grossesse; curetage; méthode
Pays / Régions : Kenya; MexiqueRésumé : In much of the developing world, sharp curettage (SC) is the most commonly used technique for treating incomplete abortion. The procedure is usually performed in a hospital setting where physicians and operating theatres are available; it often involves light to heavy sedation for pain control and an overnight hospital stay for patient recuperation and monitoring. This study examined the hypothesis that use of manual vacuum aspiration (MVA)--a variation of vacuum aspiration (VA)--would be less costly than SC and thus be advantageous to healthcare systems with limited resources. The purpose of the study was to identify and, where possible, to explain the factors that contributed to cost differences between MVA and SC for treatment of incomplete abortion. To achieve this objective, researchers observed patient management and documented resource use at hospital sites in Kenya and Mexico. The results of the study support the researchers' hypothesis that, in most cases, treatment with MVA required a shorter patient stay and fewer hospital resources than SC, as the two techniques were practiced at the various study sites. The policy decision to adopt MVA, supported by procurement of instruments and incorporation of training in its use, is the basic prerequisite to achieving reduced levels of resource use. The study results also suggest that the full advantages of MVA can be realized only if it is introduced in conjunction with certain changes in patient management, such as offering outpatient treatment for incomplete abortion.
Source : Source : Social Science Medicine.Article de périodique
Mpangile G.S.; Leshabari M.T.; Kihwele D.J.
Factors associated with induced abortion in public hospitals in Dar es Salaam, Tanzania
1993 - Reproductive Health Matters, 2), p. 21-31
Mots clés : enquête; complication; coût; adolescence; adolescent; demande; sexualité; contraception; méthode contraceptive; avortement; contraception d'urgence; contraception postcoitale; planning familial; jeune; adolescent; âge; population; facteur démographique; éducation; comportement
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In an exploratory study of illegal abortion in Tanzania, 455 women who presented to public hospitals in Dar es Salaam with incomplete or septic abortion were interviewed by hospital nurses. 33% were 14-19 years of age 46% had not been pregnant before and 24% claimed to have become pregnant at first intercourse. Close to a third of the teenagers reported a male partner 45 years of age or older. 45% were not aware of any method of contraception, presumably because of Tanzania's policy of restricting family planning information and services to married couples. Of the 17% who were using contraception at the time pregnancy occurred, 4% were using the pill, 4% the condom, 1% the IUD, 6% rhythm, and 1% withdrawal. The responsible male partner was the first person informed about the pregnancy in the majority (53%) of cases; male partners were also the informants most likely (56%) to urge abortion. The main reasons cited by subjects for terminating the pregnancy were student status, an insufficient time interval since the last birth, or economic hardship. 44% of male sexual partners paid for the abortion, yet female friends and close female relatives were most likely to facilitate arrangements for the procedure. Of the 384 abortionists described by subjects, 22% were identified as doctors (not validated), 65% as "other health workers," and 13% as "quacks." 56% of procedures occurred in a health facility and 42% were performed in a bedroom. 51% were advised by the abortionist to go to the hospital after the procedure and 35% were given medication. 84% were in fair or poor condition at admission; fever, heavy bleeding, genital trauma, and septicemia were the most frequent symptoms. Although no deaths occurred, 3 women required laparotomies. The cost to the Ministry of Health for a 1-day stay in the hospital for treatment of abortion-related complications is 7 times greater than the Ministry's annual health budget per person, and most stays exceed this. Involved health care workers expressed concern about this disproportionate yet preventable drain on the health budget and the social injustice that forces poor women to resort to unsafe abortion while more privileged women can afford private clinics. A reassessment of the ban on sex education for Tanzanian youth is urged, given their high level of sexual activity.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Article de périodique
Armitage A.
Family planning in Maghreb: redefining responsibility
1993 - Entre Nous, 24), p. 10-11
Mots clés : programme planning familial; planning familial; genre; femme; loi; culture; attitude; psychologie; facteur psychologique; comportement; relation; facteur socio-économique; facteur économique; avortement; contraception d'urgence; contraception postcoitale
Pays / Régions : Afrique du Nord; Algérie; Maroc; Tunisie; Afrique; Afrique Francophone; Pays arabes; Pays MéditerranéensRésumé : In Maghreb, men often influence women's family planning decisions including the methods they choose. Traditional religious and cultural customs, as well as legal dicta, emphasize the responsibility of men over wives and family. A survey conducted in Algeria showed that out of 47% of married women in reproductive age who had never used contraception, 12% cited the opposition of their husbands/partners and 4% had quit contraceptive use because of partner pressure. Acceptors also prefer oral contraceptives because of the fear that IUDs can be discovered. The husband is required to sign a written consent form for tubal ligation; de jure in Morocco and de facto in Tunisia and Algeria. Tunisia is the only country which allows abortion on request up to the 3rd month of pregnancy without consent of the partner. In Algeria an Morocco, abortion is illegal except for maternal health or legal reasons with partner approval. In Algerian society, however, women have traditionally used their fertility for negotiating better status in the extended family comprising mother-in-law, father-in-law, son, and daughter-in-law. The only source of power of the daughter-in-law is producing offspring, preferably sons. Family programs in Maghreb must center on the increasing acceptability of family planning programs while sensitizing males to grant more freedom to wives. Such a program is underway through the Moroccan Association for Family Planning. Similarly, in Tunis a new program targeting males has been developed. Partner communication is an essential component of this, particularly in rural areas where family planning is still taboo. The redefinition of male responsibility and equality in decision-making increases the acceptability of family planning and promotes the status of women within the family and society.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 092254.Article de périodique
Asser I.
Family planning issues in abortion care
1993
Mots clés : soin post-abortum; planning familial; counseling; avortement; politique; programme; santé de la reproduction; clinique; hôpital; service de santé; programme; contraception d'urgence; contraception postcoitale
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This account makes a case for the necessity of postabortion family planning (FP) at Muhimbili, the University Teaching Hospital in Dar es Salaam, Tanzania. The author states that abortion-related conditions account for 50-70% of all gynecological admissions in Dar es Salaam, with 30-60% of these being induced abortions. Postabortion FP is usually not provided because of the heavy patient load (200% occupancy in Muhimbili's 2 gynecological wards), administrative or logistical restrictions on its provision (the FP Clinic at Muhimbili only operates on Mondays), and a lack of knowledge and experience regarding how to deliver these services. The author suggests training the entire ward staff in basic FP information and services, training the non-FP nurses in counseling techniques with a special emphasis on postabortion methods, and training dedicated midwife counselors to administer information and methods on the gynecology wards. The author hopes that these suggestions will be implemented in hospitals throughout Dar es Salaam and will decrease the incidence of repeat abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101359.Article de périodique
Shapiro D.; Tambashe B.O.
Fertility and the status of women in Kinshasa
1993 - 325-350
Mots clés : enquête; fécondité; femme; éducation; travail; mariage; état matrimonial; contraception; méthode contraceptive; taux; étudiant; scolarisation; méthodologie; analyse; population; facteur démographique; facteur socio-économique; facteur économique; nuptialité; état matrimonial; mariage; planning familial; avortement; contraception d'urgence; contraception postcoitale
Pays / Régions : Zaïre; Afrique Centrale; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Fertility behavior and the status of women in Kinshasa, Zaire's capital are examined controlling for age, marital status, migration status, and ethnic group. Difference in lifetime fertility and in key proximate determinants of fertility by education and employment status, and how these differentials are related to women's status were studied using data of a sample of approximately 2400 women of reproductive age from a household survey carried out in Kinshasa during the 2nd quarter of 1990. The survey provided sample sizes for examination of fertility of women employed in the modern sector, in the informal sector, as well as those not employed, and women with secondary and university-level education. Zaire's 1984 Census showed that more than 55% of the youngest women in Kinshasa had reached secondary school. School enrolment rates for the 10-14 year old age group were nearly 90% for females; in the 15-19 year old age group, 66% of females were in school compared with about 85% of males. It was estimated that 66% of the women aged 13-49 had gone beyond primary school. The 1984 Census showed that about 40% of women aged 25-54 participated in the labor force compared with roughly 90% for men. Lifetime fertility for women employees was typically lower than that of either nonemployed or self-employed women. Multivariate analyses showed that almost 80% of ever-sexually-active women reported having ever used contraception, while overall contraceptive use was an estimated 44%. Under 4% of ever-pregnant women with no schooling reported having had an abortion compared with nearly 10% of those with primary school education, 21% of women with secondary school education, and 33% of women with university education. 13-14% of both unemployed women and those working in the informal sector reported having had an abortion compared with nearly 30% of women employed in the modern sector. Education was associated with deferral of marriage, shorter periods of breast feeding, and an inverse relationship to postpartum abstinence.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 084950.Congrès
Mundigo A.I.
Health and social aspects of induced abortion: an overview of research needs.
1993 - International Population Conference, Montreal 1993,, 203-208 p.
Mots clés : avortement; morbidité; facteur socio-économique; psychologie; facteur psychologique; prévalence contraceptive; santé publique; programme planning familial; politique; programme; contraception d'urgence; contraception postcoitale; planning familial; maladie; complication; facteur économique; comportement; contraception; méthode contraceptive; santéRésumé : It is estimated that 20-30% of maternal deaths results from complications of unsafe induced abortions in many developing countries. Poor quality legal abortion can still be a serious health problem as in India and in parts of Central Europe and the former Soviet Union, where induced abortion remains a primary means of fertility regulation. There are around 35-55 million annual abortions, of which some 26-31 million are legal. It is estimated that at Kenyatta National Hospital in Nairobi, some 10,000 admissions a year are attributed to complications from incomplete abortion. Central European countries, parts of the former Soviet Union, and China (with some 10-11 millions abortions/year) have low fertility owing to different mixes of abortion and contraception. Women in Central and Eastern Europe have up to 6-7 abortions/each 10 conceptions. At these levels abortion becomes the main method of birth control. As M.E. Khan's paper reports, in India in 1990, legal abortions reached nearly 600,000, the official estimate. The more believable annual estimate of induced abortion is somewhere between 5 and 6 million with the more well-to-do women obtaining legal abortion, while poorer women resort to illegal, unsafe abortions. A study conducted in Mexico City by Pick de Weiss indicates that untrained employees in pharmacies provide inefficient and/or dangerous drugs or herbal preparations to abort. Studies in Latin America indicate that younger unmarried women are most exposed to risks of morbidity and mortality. The paper by Anderson, Katus, Puur, and Silver on Estonian women found that because of late gestational age abortions, single women are most likely to face severe complications and health risks. The paper by Sbatello describes the Israeli policy situation and the rise in abortion in recent years, mainly among large numbers of Soviet immigrants using abortion as a primary means of fertility control. The study of abortion should be a priority for demographers, epidemiologists, health and population policy experts, and women's rights advocates.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 084942.Article de périodique
Ogedengbe O.K.; Giwa Osagie O.F.; Hord C.E.
Improving abortion care at the intermediate level through use of manual vacuum aspiration: results from Nigeria
1993
Pays / Régions : NigeriaRésumé : The purpose of this report is to present several ways to reduce the high maternal mortality rate in Africa, which is often caused by unsafe abortion. The report focuses on how manual vacuum aspiration (MVA) can improve abortion care at the intermediate level of the health system, since MVA entails a minimal need for pain control measures, requires no electricity, and can be performed on an outpatient basis. Statistics show that maternal mortality is highest in west Africa (760 deaths/100,000 live births) and that between 25-50% of these deaths are caused by illegal abortion that results from a lack of family planning (FP) services or the lack of availability of safe abortion procedures. The authors proposed several solutions to this problem: 1) liberalize restrictive abortion laws; 2) improve the management of incomplete abortion cases, especially by introducing MVA for use in decentralized service delivery settings to make treatment more accessible to rural women; and 3) prevent unwanted pregnancies by increasing access to FP services and educating the public about the benefits of child spacing.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101343.Article de périodique
Ogedengbe O.K.
Improving abortion care in Nigeria -- a case study
1993
Pays / Régions : NigeriaRésumé : This report on the introduction of the manual vacuum aspiration (MVA) technique for uterine evacuation in Nigeria and other sub-Saharan African countries and the impact of MVA on the quality of abortion services opens with a discussion on abortion in Nigeria and the MVA equipment. The author then discusses the MVA provider training programs in Nigeria, which were begun by IPAS (International Projects Assistance Services) in 1987 at 4 teaching hospitals and have trained 575 health care providers from 12 teaching hospitals and 10 secondary hospitals in 10 states. 366 incomplete abortion patients were treated with MVA over a period ranging from 3 to 18 months usage at these 4 hospitals. Almost half (49%) of the patients were 20-29 years old, while 12% were 10-19 years old; over half had more than 7 years education, while 30% had none. MVA was performed with equal safety by all levels of providers, and 90% of the procedures were performed on an outpatient basis (no patient was admitted overnight). Pain control measures were minimal (18% were given pain control), but use of antibiotics was liberal (73% of patients). Complication rates were low (0.2% of the over 2000 procedures performed at Lagos University Teaching Hospital). Most (68%) of the patients counseled for postabortion family planning accepted a method, compared to 8% of the noncounseled patients. The author then discusses IPAS' training programs and their results in Kenya, Zambia, and Zimbabwe and concludes that more widespread use of MVA will lead to a substantial decrease in maternal mortality from abortion complications in Africa.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101345.Article de périodique
Rogo K.O.
Induced abortion in Kenya
1993
Mots clés : programme planning familial; avortement; politique; programme; planning familial; contraception d'urgence; contraception postcoitale
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This paper discusses the situation of induced abortion in Kenya. Although trends in contraceptive prevalence have been encouraging, unwanted pregnancies and abortions continue to increase. Despite implementation of restrictive law, many women still resort to abortions that result in serious socioeconomic and health consequences. With the existing sociopolitical climate in Kenya, other alternatives were undertaken which could greatly benefit those who may need abortion services. These include 1) comprehensive information, education and communication/family planning (FP) education programs to communities, leaders and the youth; 2) accessibility of contraception services to all sexually active individual; 3) training and expansion of manual vacuum aspiration services in both public and private sector; and 4) provision of quality postabortal counseling and contraceptive services. Moreover, it was observed that the current FP services focus on the married woman and on preventing pregnancy; thus, neglecting those women with unwanted pregnancy due to inaccessibility of services or contraceptive failure. This paper concludes that the many organizations that provide FP services in Kenya could easily broaden their approach to encompass all aspects of reproductive health, including abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 146569.Article de périodique
Rogo K.O.
Induced abortion in Sub-Saharan Africa
1993 - East African Medical Journal, 70(6), p. 386-395
Mots clés : loi; soin; santé de la reproduction; avortement spontané; fausse couche; complication; grossesse non prévue; grossesse non désirée; grossesse adolescente; grossesse; politique; programme; mortalité maternelle; contraception d'urgence; contraception postcoitale; planning familial; santé; complication grossesse; maladie; complication; fécondité; population; facteur démographique; mortalité
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : There is confirmation from hospital-based studies that unsafe abortion and complications have been the cause of up to 50% of maternal deaths in sub Saharan Africa. In this article, estimates of induced abortion are discussed as well as abortion law and abortion services from an African perspective. Future prospects for resolving the abortion issues are hampered by fear and restrictions. Recommended strategies for decreasing he undesirable outcomes of botched abortions were 1) improvement in the availability of good health care including drugs and referrals, 2) improvement in accessibility of contraceptive services and involvement of males in decision making, 3) introduction of appropriate and simple technology for performing safe abortions, 4) increases in access to affordable abortion services, and 5) active education and involvement of local women's groups regarding fertility reproduction and abortion. The development of an effective abortion program is dependent on a reliable health service infrastructure, which includes lamps, examination tables, and sterilization equipment. The WHO has recommended vacuum aspiration for uterine evacuation and induction of abortion or treatment of complications at the first referral level. The current availability of this equipment is limited. Also recommended is the training of medical and nonmedical personnel in the use of Karman's syringe and cannula. Consideration should be given to provision of abortion services at local health centers and dispensaries rather than in big hospitals. Constructive dialogue with lawmakers is also important for easing restrictions. Abortion must be a part of reproductive health agendas. The extent of unwanted pregnancy is apparent from news articles about abandoned newborns in schools, or deaths of honor students in rural areas who learned in class about health for all, but were unable to experience it in real terms.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 091505.Article de périodique
Anonymous
Influencing South African abortion policy
1993 - Reproductive Health Matters, 2), p. 140-141
Mots clés : politique; programme
Pays / Régions : Afrique du SudRésumé : High rates of illegal abortion in South Africa have occurred despite the legalization of abortion. In 1991, there were 1024 legal abortions and an estimated 42,000 to 167,000 illegal abortions. In 1984 there were 7400 women treated for incomplete abortions in Cape provincial hospitals. In a 15-month period between 1983 and 1985, there were 2450 post-abortion admissions, of which 647 were for sepsis; twelve women died. At Kalafong Hospital in Pretoria between 1985 and 1988, there were 4058 admissions for complications from illegal abortions, of which 811 were due to sepsis; 33 received hysterectomies as a result. Those treating the complications of abortion estimate that the number of illegal abortions is probably closer to 200,000. The reason for illegal abortion may be related to the attitudes of health care nurses (PHCNs) in public health clinics. In a survey of 35 primary health care clinics, the interviews with PHCNs revealed that 70% unambiguously rejected abortion and found it unacceptable under any circumstances. The responses indicated a harsh, judgmental tone, without considerations for the problems of women. The opposition to abortion appeared to be rooted in the belief that unwanted pregnancy or abortion were a sign of an uncaring, irresponsible woman and mother. The termination of pregnancy was equated with termination of motherhood and womanhood. Community health clinics will be providing the backbone of health services in the coming years, and concern was raised about how to handle provision service with negative attitudes operating among the PHCNs. The Black Sash in April of 1993 recommended at their national congress that a clause be added to the Bill of Rights that stipulated that the right to life should not belittle or take away from the woman's right to choose an abortion; those holding strong beliefs against abortion and holding a medical job can decline to perform abortions, but must provide and facilitate adequate and nondirective counseling for women considering termination. The changes in the Bill of Rights would repeal conflicting clauses of the old abortion statute. A complete statement of the new provision was given.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.Thèse
Odutayo M.O.
Les avortements : aspects épidémiologiques, cliniques et anatomo-pathologiques et thérapeutiques
1993 - Faculté de médecine, Abidjan, 57
Source : Source : Ceped.Article de périodique
Paul B.K.
Maternal mortality in Africa: 1980-87
1993 - Social Science Medicine, 37(6), p. 745-752
Mots clés : naissanceRésumé : African women of reproductive age have the highest death risk from maternal causes of any women in the world. The lifetime chance of maternal death is 1 in 21 in Africa as compared to 1 in 54 in Asia, which ranks second. Using published data, this paper examines the level and correlates of maternal mortality ration (MMR) in Africa. The data indicates that MMR greatly differs among the countries of Africa. High MMR is found in most countries of sub-Saharan Africa, while countries of Northern Africa are characterized by relatively low maternal death. Reasons for high MMR in sub-Saharan Africa are explored in detail. Analysis using multiple regression suggest that the MMR in Africa is strongly influenced by population size, crude birth rate (CBR), crude death rate (CDR), calorie supply as a percentage of requirements, access to safe water, and percentage of urban population. Some cultural and behavioral factors, such as female circumcision and infibulation, are also associated with a high MMR. Future programs aimed at reducing the maternal mortality in African countries may benefit from the findings of this study.
Source : Source : Social Science Medicine.Article de périodique
Mbizvo M.T.; Fawcus S.; Lindmark G.; Nystrom L.
Maternal mortality in rural and urban Zimbabwe: social and reproductive factors in an incident case-referent study
1993 - Social Science Medicine, 36(9), p. 1197-1205.
Mots clés : adolescence; adolescent; adulte; âge; enquête; femme; homme; âge; mortalité maternelle; fécondité; rural; résidence; facteur socio-économique; ville; résidence; épidémiologie
Pays / Régions : ZimbabweRésumé : A community-based incidence case-referent study was undertaken in a rural and an urban setting in Zimbabwe in order to define risk factors associated with maternal deaths at family, community, primary and referral health care levels. Referent subjects were drawn from place or area of delivery for each consecutive maternal death. Using a multiple source confidential reporting network for all maternal deaths, the maternal mortality rate for the rural setting was 168/100,000 live births and that for the urban setting was 85/100,000 live births. A model for interacting factors contributing to maternal mortality was designed. Haemorrhage and abortion sepsis were the major direct causes while malaria was the leading indirect cause in the rural setting. In the urban setting, eclampsia, abortion and puerperal sepsis were the leading causes of maternal deaths. It was found that all situations associated with diminished, or absent social support, that is, being single (Odds Ratio = 4.7, 95% CI = 2.2-9.8) divorced, widowed, one of several wives, cohabiting, or self-supporting carried an increased risk for maternal mortality, especially in the rural area. Income and level of education for index and referent subjects were comparable, probably because of the limited part of the population under study that belonged to a more affluent class. Distribution of cases and referents by religious-affiliation was also comparable. Age > 35 years and parity > 6 were significant risk factors for maternal mortality in the rural setting, whereas bad reproductive history with reported stillbirth or abortion constituted a high risk both in the city and in the rural areas (Odds Ratios 4-6).(ABSTRACT TRUNCATED AT 250 WORDS)
Source : Source : Social Science Medicine.Article de périodique
Bugalho A.; Bique C.; Almeida L.; Bergstrom S.
Pregnancy interruption by vaginal misoprostol
1993 - Gynecologic and Obstetric Investigation, 36(4), p. 226-229
Mots clés : méthodologie; médicament; Misoprostol; méthode; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : While the early interruption of pregnancy is legal in Mozambique, demand for abortion exceeds available resources. The authors explored the ability of a vaginally-administered prostaglandin analog, misoprostol, to induce safe and effective abortion among a sample of 132 pregnant women of average gestational age 14.2 weeks. The volunteers were of mean age 23.3 years in the range of 14-45 years undergoing legal abortion 11-22 weeks post-conception. 106 women received a dose of 800 ug, while 26 received 1200-1600 ug. The fetus was expulsed without surgery in 117 cases and four cases were excluded for social reasons. Fetal expulsion did not, however, occur among eleven subjects within 56 hours of the administration of the drug and thus constitute therapy failures. The almost 80% abortion success rate with a 10-15 ug dose per kilogram body weight, however, points to the high effectiveness of vaginally-administered prostaglandin to induce safe abortions without significant complications. Since the drug does not have to be stored at cool temperatures, it has important potential for use in developing countries. Misoprostol could even be administered by properly-trained nurses or midwives.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 099884.Article de périodique
Wachuku King S.
Quality of care and women's perspective and needs for post-abortion family planning services: a Sierra Leone experience
1993
Mots clés : service de santé; grossesse non prévue; grossesse non désirée; maladie sexuellement transmissible; MST; IST; santé de la reproduction; régulation menstruelle; avortement; loi; soin post-abortum; counseling; planning familial; demande; soin; santé; fécondité; population; facteur démographique; IST; MST; infection; complication; maladie; complication; programme; contraception d'urgence; contraception postcoitale; clinique; hôpital; service de santé; facteur économique
Pays / Régions : Sierra Léone; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This report is an overview of the work of the Marie Stopes Society in Sierra Leone. The aim of the society is to provide low-cost reproductive health care for low-income families in order to reduce the maternal morbidity and mortality that results from unwanted pregnancies and sexually transmitted diseases (STDs). Abortion is illegal in Sierra Leone, but it is widely practiced nonetheless. Data were collected on menstrual regulation (MR) patients (n=286) at the Marie Stopes Society clinic(s) over a 3-month period (March-May 1992). The results were as follows: 1) the majority of the patients were 15-25 (73%) and educated (82%); 2) 58% of the patients had had at least 1 previous pregnancy; 3) 31% of the patients had undergone at least 1 previous MR procedure; and 4) 56% of the patients accepted family planning after the MR procedure. In addition, the report includes the responses to a simple questionnaire given to abortion clients (age range 16-30) and a few of their male partners. The author concludes that the answers to this questionnaire can give insight into where to strengthen counseling services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101367.Article de périodique
Anonymous
Report on the use of induced abortion in Mauritius: alternative to fertility regulation or emergency procedure?
1993
Mots clés : contraception; méthode contraceptive
Pays / Régions : MauriceRésumé : To facilitate informed consideration of the issue of abortion, the Mauritius Family Planning Association (MFPA) interviewed 475 women admitted to 3 large government hospitals with complications of self-induced or clandestine abortion. Although abortion is strictly illegal in Mauritius, extrapolation of hospital data suggests at approximately 10,000 procedures (52% of live births) are performed each year. The study sample included the 90% of women admitted to the 3 hospitals in january-April 1992 who agreed to provide qualitative and quantitative information. The mean age of study subjects was 28.3 years; 32% were under 25 years of age. 91% already had at least 1 living child. The sample was evenly divided between urban and rural residents. Only 274% had attended secondary school. 93% used a crude and/or self-induced method (insertion of bicycle spokes into the vagina, herbs, misoprostol ingestion); 20% of procedures were performed in the second trimester. Before the abortion, only 31% were using a supplied method of contraception; 12% used condoms, 9% relied on natural family planning, 33% used withdrawal, and 17% were not using any method. Ministry of Health clinics and pharmacies, not MFPA facilities, were the major source of supplies. Qualitative analysis revealed these women to have different needs, attitudes, and behaviors based on their stage in the family cycle (unmarried, delayers, spacers, and stoppers). In this sample, women who desired no further births were the largest grouping (62%), followed by birth spacers (23%). Post-abortion, 63% of women indicated they planned to use a modern method of contraception. Most significant was the intent of 27% of stoppers to seek sterilization. Despite their hospitalization, 16% of unmarried subjects, 13.6% of delayers, 6.4% of spacers, and 34.1% of stoppers reported they would consider another abortion. This finding suggests that abortion is viewed, by many, as an alternative method of fertility regulation. Most families in Mauritius accept the small family norm; the challenge is to increase the volume of family planning services to meet this demand, make sterilization part of public health care services, and identify subgroups at greatest risk of nonuse or ineffective use of contraceptives.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html -PIP 094229.Ouvrage
Bledsoe C.H.; Cohen B.
Social dynamics of adolescent fertility in Sub-Saharan Africa
1993 - Washington: National Academy Press, 208p p.Résumé : Adolescent fertility tends to be valued and sanctioned in the countries of sub-Saharan Africa when parents have had adequate ritual or training preparation for adulthood and the child has a recognized father. Young women and adolescents who conceive and bear children within this context are widely accepted by society; those who conceive outside of marriage, however, are strongly condemned by society. Over the past 2-3 decades, most African countries have successfully raised their levels of education. Girls and women are increasingly privy to formal school education and training in trade apprenticeships, domestic service, and ritual initiation which had otherwise been denied in the past. These factors, combined with declining menarche in a few areas, and changing economic opportunities, law, and religion make it more difficult to define the exact date of entry into marriage. Many girls are taking advantage of these changing circumstances and their opportunities to obtain educations and resist early marriage and cildbearing. While defying the traditional entry into early marriage, many young women do not, however, refrain from engaging in sexual activities. Pregnancies to unwed mothers are thereby on the rise and may constitute the most profound change observed in the social context of adolescent fertility on the continent. Once pregnant, many women find themselves shut out by family planning programs and prenatal clinics which serve only married women. This paper ultimately concludes that the social context of adolescent childbearing has an effect on the outcome for mother and child which is as important as the physiological maturity of the mother.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 090542.Article de périodique
Bugalho A.; Bique C.; Almeida L.; Faundes A.
The effectiveness of intravaginal misoprostol (Cytotec) in inducing abortion after eleven weeks of pregnancy
1993 - Studies in Family Planning, 24(5), p. 319-323
Mots clés : médicament; aspiration; méthode; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Mozambique; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique LusophoneRésumé : At Maputo Central Hospital in Mozambique, intravaginal misoprostol, a PGE2 methyl-analogue, was used by 169 women whose request for interruption of pregnancy had been approved. The drug was used by women who had completed between 12 and 23 weeks of gestation. The initial dose was 800 mcg, repeated 24 hours later if abortion had not occurred or was not in progress. The treatment was considered a failure when abortion was not advanced by 48 hours after the initial dose, and curettage was performed in all but one of such cases. During the course of the study, the dosage was successively reduced to 600, 400, and 200 mcg. Abortion was successfully induced in 154 women (91.1%); there were 10 failures (5.9%), and 5 women (3.0%) dropped out of the study. The mean time from initial dose to abortion was 14.3 hours. No significant association of success rate and time from dosage to expulsion was found with age, parity, prevention abortion, or gestational age. Preventive vacuum aspiration of the uterine cavity was carried out on all subjects. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 091406.Article de périodique
Otsea K.
The place of abortion care in safe motherhood programs
1993 - Journal of Obstetrics and Gynaecology of Eastern and Central Africa, 11(1), p. 3-7
Mots clés : avortement; complication; mortalité maternelle; santé; loi; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; mortalité; population; facteur démographique
Pays / Régions : Afrique Subsaharienne; Kenya; Afrique; Afrique de l'Est; Afrique AnglophoneRésumé : This paper presents steps that safe motherhood programs can take to address the problem of unsafe abortion. The author discusses studies and training programs throughout the 1980s and 1990s in all regions of the world, with a focus on sub-Saharan Africa, particularly Kenya. Previous studies have shown abortion-related mortality in Africa to be extremely high, ranging from 20 to 80% of all maternal deaths. The author identifies 2 strategies for decreasing maternal mortality due to unsafe abortion: 1) improving abortion services by improving the treatment of abortion complications; decentralizing safe abortion services; and providing postabortion family planning services and 2) liberalizing the abortion law and removing or revising policies that restrict access to services, such as the uneven distribution of authorized providers in the urban, tertiary facilities; the restrictions on the types of providers who can perform the services; and the administrative requirements that must be met before the procedure can be performed (e.g., committee approval and multiple signatures from certified physicians). Based upon the high levels of maternal mortality because of unsafe abortion, the author concludes that safe motherhood programs have a responsibility to address this issue and to incorporate some of the suggested changes into their programs.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101416.Article de périodique
Naamane Guessous S.
Traditional methods still widely used
1993 - Planned Parenthood Challenges, 1), p. 14-16
Mots clés : loi; demande; Islam; religion; sage-femme; personnel de santé; sexualité premaritale; avortement; contraception d'urgence; contraception postcoitale; planning familial; religion; personnel de santé; soin; santé; sexualité; comportement
Pays / Régions : Maroc; Afrique Francophone; Afrique; Afrique du Nord; Pays arabes; Pays MéditerranéensRésumé : Although Moroccan law allows abortion only if a woman's life is endangered, illegal abortion--often performed by traditional midwives using dangerous methods--is widespread. In a 1984 survey of 125 married women, 49 reported at least 1 abortion and 19 of these women had not consulted with their husband about this decision. 23 of these abortions were performed by traditional midwives. Many abortion seekers are unmarried women who face ostracism from Moroccan society should they carry a pregnancy to term. The ban on abortion has produced a network of physicians who will perform clandestine abortions in private clinics or their own surgeries. The cost range is US$95-175, placing it out of the reach of low-income women. Needed is access to effective contraception and safe abortion services. However, such measures will require Islam leaders to accept that growing numbers of Moroccan youth are engaging in premarital sex and abandon their stance that all abortion seekers are sexually promiscuous unmarried women.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 092621.Article de périodique
Deganus Amorin S.
Unsafe abortion and the Safe Motherhood Initiative in Sub-Saharan Africa
1993
Mots clés : complication; avortement; aspiration; méthode; service de santé; complication grossesse; maladie; complication; contraception d'urgence; contraception postcoitale; planning familial; soin de santé primaire; soin; santé
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : The focus of this paper is unsafe abortion in sub-Saharan Africa. The author's purpose is to encourage safe motherhood programs to tackle the problem of unsafe abortion and to examine what is currently being done to combat the problem. The author argues that, with the exception of the implementation of manual vacuum aspiration (MVA) programs, there are no direct activities dealing with the problem of unsafe abortion in any of the regional safe motherhood programs. The author determined that the only safe motherhood activities that have been carried out as of yet are: research activities aimed at determining the true maternal health situations in countries; strategies to strengthen obstetric health care and family planning service delivery; and health education activities on safe childbearing. The author suggests that these programs should focus on preventive interventions such as primary strategies that include health education activities; secondary strategies that promote safe and accessible abortion services; and tertiary strategies to ensure that complications of induced abortion are quickly recognized as life-threatening and managed appropriately to reduce morbidity.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101428.
1991Article de périodique
Foreit K.; Northman D.
A method for calculating rates of induced abortion
1992 - Demography, 29(1), p. 127-137Résumé : Abstract: An indirect method for calculating marital induced abortion rates from observed marital fertility and contraceptive prevalence, and modeling the impact of substituting contraception for abortion on fertility in the future is presented. Estimates for Belo Horizonte, Brazil, Lima, Peru, and La Paz, Bolivia are generated using this method. The model for proximate determinants of fertility uses the same data and statistical assumptions. Observed marital fertility equals an assumed biological maximum adjusted multiplicatively by an index of postpartum infecundability or postpartum abstinence, less the sum of births averted by contraception and induced abortion. The theoretical maximum fertility rate, or the total fecundity rate, is assumed to be an average of 15 live births for sexually active women aged 15-49, which will overestimate induced abortion rates. The findings of the country analyses were that the inferred abortion rates were quite high for all 3 countries. The lifetime abortion range was 6 in La Paz to >4 in Belo Horizonte and Lima. The highest rates were 6.5 for Social Security Beneficiaries in La Paz. Demographic and Health Survey data indicated 1.5 abortions/woman. An explanation of the difference in rates is provided which adjusts for the differences in contraceptive prevalence and effectiveness, and yields a 4.04 or 5.52 average/woman. An analysis of rates of hospitalization from abortion complications shows working women in La Paz with a higher rate. However, using age-specific ratios of observed complications to inferred total abortions for all 3 countries was not an effective validity check. The results of projecting the impact of substituting contraception for abortion were that .4 fewer lifetime births/woman would be averted. If induced abortion rates are stable, increases in contraceptive prevalence and effectiveness should generate a reduction in total marital fertility of 24%, i.e., from 5.89 to 4.45 births. If the total marital rate is decreased by 26% or from 1.48 abortions to 1.08 abortions as contraceptive prevalence increase, the decline in fertility would be 17.5% or from 5.89 births to 4.86 births. Although the inferred abortion levels for the 3 countries were high, Tietze and Bongaarts demonstrated similarly high figures for countries in the course of demographic transition. Resource allocation should take into account both current abortion levels and potential substitution with contraception.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 070846.Article de périodique
Lema V.M.; Kabeberi Macharia J.W.
A review of abortion in Kenya
1992
Mots clés : revue littérature; avortement; demande; facteur socio-économique; contraception; méthode contraceptive; religion; législation; adolescence; adolescent; loi; contraception d'urgence; contraception postcoitale; planning familial; facteur économique; jeune; adolescent; âge; population; facteur démographique
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In order to form a basis for future research, the Centre for the Study of Adolescence attempted to document all that has been done and is known about abortion in Kenya. The specific goals of the project were to identify, summarize, and disseminate all the Kenyan research on abortion and the pertinent legal information as well as to highlight the lessons learned and suggest future activities and research. The first chapter of this book contains an introduction and description of the study methodology. In the second chapter, abortion is discussed in terms of its definitions (cut-off points in terms of gestational age or fetal weight), the magnitude and regional variations in the occurrence of abortion, types of abortion, and the gestational age at which most abortions occur. Chapter 3 provides sociodemographic information about abortion seekers including age, marital status, education, occupation, reproduction and contraception history, religion, and reported status of male partners. The fourth chapter covers what is known about the effects of abortion as well as its treatment and costs. Chapter 5 details the provisions of constitutional law (the right to life) and statutory law (dealing with abortion in general, supplying an implement of abortion, killing an unborn child, concealing a birth, advertising drugs or appliances for abortion, and distinctions between killing an unborn child and the murder of a newly-born child) which apply to abortion. The sixth chapter deals with studies of abortion among adolescents. Conclusions and recommendations derived from the review are presented in chapter 7 and include the facts that most of the women treated in hospitals for abortions are aged 20-25 years and are or have been married, but single women have the highest incidence of abortion complications. Most of the women were not using contraception but reported that their pregnancy was unplanned. Also, most of the women were unemployed or still in school. Additional research is recommended as is a review of the law and an increase in the provisions for legal abortion. The CSA intends to continue its work in research, education, and advocacy to improve conditions for women. The eighth chapter is composed of summaries of the literature reviewed, and the final chapter summarizes a selected number of court cases.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 104396.Article de périodique
Kidula N.A.; Kamau R.K.; Ojwang S.B.; Mwathe E.G.
A survey of the knowledge, attitude and practice of induced abortion among nurses in Kisii district, Kenya
1992 - Journal of Obstetrics and Gynaecology of Eastern and Central Africa, 10(10), p. 10-12
Mots clés : enquête; infirmier; personnel de santé; avortement; loi; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; personnel de santé; soin; santé
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : A cross-sectional study was carried out in Kisii District in the western part of Kenya between April 1 and April 28, 1991, with the objectives of ascertaining the attitude of nurses towards induced abortion, patients, and their involvement in abortion. Data were collected using a structured, self-administered questionnaire. All nurses present at the various institutions were recruited. A total of 218 nurses were recruited into the study. 75-83% were married, female nurses younger than 40, and therefore in the reproductive age group. 134 (61.5%) nurses were Protestant and 51% worked in the government district hospital. The nurses displayed a deficient knowledge of all aspects of induced abortion. Among clinically safe methods only intraamniotic saline instillation and dilation and curettage were mentioned by 4% and 11%, respectively. This deficiency in knowledge may be explained by the fact that most nurses work in the government hospitals, where induced abortion is not a routine procedure. Only 26-28% of the nurses thought it was safe to induce abortion at 1 and 2 months of gestation. 31-43% either did not know or were uncertain. Abortion is illegal in Kenya except when the life of the mother is in danger. Most nurses seemed to favor the law. A previous study in Nairobi revealed that only 38% of the nurses favored abortion on demand under a liberalized abortion law. 24 (11%) of nurses admitted to have induced abortion before. Their knowledge of induced abortion needs to be improved in order to prevent an increase in mortality and morbidity associated with improperly performed abortions.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101420.Article de périodique
Justesen A.; Kapiga S.H.; van Asten H.A.
Abortions in a hospital setting: hidden realities in Dar es Salaam, Tanzania
1992 - Studies in Family Planning, 23(5), p. 325-329
Mots clés : avortement; avortement spontané; fausse couche; attitude; loi; contraception; méthode contraceptive; grossesse non prévue; grossesse non désirée; taille famille; famille; prévalence contraceptive; programme planning familial; âge; demande; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; psychologie; facteur psychologique; comportement; santé de la reproduction; fécondité; population; facteur démographique; facteur économique
Pays / Régions : Tanzanie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This study investigates the extent of unwanted pregnancy, the use of illegally induced abortion, and the attitudes toward and practice of contraception among women admitted to a hospital with the diagnosis of abortion in Dar es Salaam, Tanzania. (In Tanzania, induced abortion is permitted only to save the mother's life). A random sample of 300 women with early pregnancy loss admitted to Muhimbili Medical Center, the teaching hospital in Dar es Salaam, were interviewed between September and November 1987, using a structured questionnaire. Among the 300 respondents, 155 said that their pregnancy had been unwanted: 94 of them presented with an illegally induced abortion and 61 with a spontaneous abortion. The number of spontaneous abortions of unwanted pregnancies increased with age and stability in a relationship. Having a small child to look after and having completed the family were the most common reasons for the pregnancy to be unwanted in this group. Induced abortion was more a problem of the young, unmarried woman. The 61 women with spontaneous abortions but unwanted pregnancies suggest that a much larger group of pregnant women continue to term with what are, at least initially, unwanted pregnancies--precisely the group of women family planning programs want to reach. The low prevalence of contraceptive use in this group indicates the failure of family planning clinics to motivate their target group. Recommendations are made for improved functioning of family planning clinics. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 080959.Article de périodique
McDougall G.; McGibbon C.
Backstreet slaughter
1992 - Weekend Argus, 13
Mots clés : complication; législation; loi; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This commentary documents the risks and consequences of illegal abortions in South Africa. It focuses on illegal abortion in the 1980s and discusses the implications of the Abortion and Sterilization Act of 1975. The authors argue from a prochoice stance the importance of providing safe abortion services to South African women to alleviate the mortality, morbidity, and psychological costs of illegal abortions. The authors clearly want to underscore the severity of the consequences of illegally-induced abortion in South Africa.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101421.Article de périodique
Elder J.P.; Estey J.D.
Behavior change strategies for family planning
1992 - Social Science Medicine, 35(8), p. 1065-1076
Mots clés : planning familial
Pays / Régions : Afrique; AsieRésumé : African women of reproductive age have the highest death risk from maternal causes of any women in the world. The lifetime chance of maternal death is 1 in 21 in Africa as compared to 1 in 54 in Asia, which ranks second. Using published data, this paper examines the level and correlates of maternal mortality ration (MMR) in Africa. The data indicates that MMR greatly differs among the countries of Africa. High MMR is found in most countries of sub-Saharan Africa, while countries of Northern Africa are characterized by relatively low maternal death. Reasons for high MMR in sub-Saharan Africa are explored in detail. Analysis using multiple regression suggest that the MMR in Africa is strongly influenced by population size, crude birth rate (CBR), crude death rate (CDR), calorie supply as a percentage of requirements, access to safe water, and percentage of urban population. Some cultural and behavioral factors, such as female circumcision and infibulation, are also associated with a high MMR. Future programs aimed at reducing the maternal mortality in African countries may benefit from the findings of this study.
Source : Source : Social Science Medicine.Article de périodique
Onuoha N.
Contributions of the proximate determinants to fertility change in Senegal
1992 - Social Science Medicine, 35(10), p. 1317-1320
Mots clés : nuptialité; état matrimonial; mariage; prévalenceRésumé : The 1978 World Fertility Survey (WFS) and the 1986 Demographic and Health Survey (DHS) data are used to examine the relative contributions of three proximate determinants (nuptiality or marriage, contraception and post-partum infecundability) to fertility change in Senegal. The aim is to identify the important variables that is amenable for policy towards fertility reduction. Analysis shows that there are increases in the absolute measures of all three determinants. The magnitude of change is greatest in contraceptive use, moderate in marriage but least in duration of breast-feeding. However, the index of contraceptive use exerts the least impact on fertility reduction while that of post-partum infecundability makes the strongest impact on fertility. The impact of the nuptiality index on fertility change lies in-between contraception and breast-feeding.
Source : Source : Social Science Medicine.Ouvrage
FNUAP
Eléments de réflexion sur les activités en matière de population au Niger
1992 - Niamey (NE): FNUAP, 45 p. p.
Mots clés : éducation
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Mottin M.H.
Féminisme et démographie. Contraception et avortement
1992 - Croissance démographique et santé en Afrique = Demographic growth and health in Africa, N° spécial), p. p. 55-65
Mots clés : contraception; méthode contraceptive
Source : Source :Ceped : http://ceped.cirad.fr.Article de périodique
Konje J.C.; Obisesan K.A.; Ladipo O.A.
Health and economic consequences of septic induced abortion
1992 - International Journal of Gynecology and Obstetrics, 37(3), p. 193-197
Mots clés : méthodologie; enquête; complication; complication; peritonite; mortalité maternelle; coût; étudiant; scolarisation; complication grossesse; maladie; complication; avortement; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique
Pays / Régions : Nigeria; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : 2 obstetrician/gynecologists analyzed June 1981-December 1987 data on 230 <15->36 year old women who presented at University College Hospital in Ibadan, Nigeria with sepsis caused by illegally induced abortion to examine the health and economic effects of induced abortion complicated by sepsis. The number of septic abortions between 1981 and 1985 was 25.4 cases/year but between 1986 and 1987 the number increased 2-fold (51 cases/year). The researchers attributed the increase of hospitalized septic abortion cases to the rapid rise of poorly equipped private hospitals where clinicians terminate pregnancies at low cost. 73.4% of the cases obtained their abortions at private hospitals or clinics. The leading clinical symptom was abdominal pain (81.3%) followed by fever (40.4%), vaginal bleeding (35.2%), and foul-smelling vaginal discharge (31.3%). The most frequent complications of the illegal abortion included peritonitis (68.3%) and pelvic abscess (26.1%). 15.6% of all cases (36) suffered from perforation and 20 of them underwent tubal ligation. Maternal mortality was 8.3%. Causes of death were in order of significance septicemia, acute renal failure, hemorrhage from perforation, hepatorenal failure, choriocarcinoma, disseminated intravascular coagulation, and cardiopulmonary failure after repair of burst abdomen. All the women received antibiotics (combination of metronidazole and either clavulanic acid and amoxycillin or ofloxacilin) and most (53%) also required suction evacuation. 17% required only antibiotics. The mean cost of treating the 230 cases was US$223.11 (range US$15-US$1624) while the minimum monthly wage in 1987 was only US$15 and minimum monthly salary was only US$45. Legalization of abortion would have saved US$50,022.28. Specifically, it would have reduced the incidence of sepsis. Reproductive health education, dissemination of reproductive health information, and provision of accessible family planning services would have decreased the number of unwanted pregnancies.
Source : Source POPLINE : http://db.jhuccp.org/popinform/basic.html - PIP 079276.Article de périodique
Mahomed K.; Healy J.; Tandon S.; Munetsi S.; Bradley J.; Leonard A.
Improved treatment of abortion complications and post-abortion family planning in Zimbabwe
1992
Mots clés : enquête; évaluation; complication; traitement; soin; morbidité; mortalité; hôpital; hospitalisation; ville; résidence; planning familial; programme planning familial; counseling; étudiant; scolarisation; méthodologie; avortement; contraception d'urgence; contraception postcoitale; maladie; complication; population; facteur démographique; service de santé; soin; santé; clinique; hôpital; service de santé; programme
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Unsafe abortion is a major public health problem in Zimbabwe. 60,000 unsafe abortions are performed each year. 30% of all maternal deaths are due to unsafe abortions. 50% of Harare Central Hospital emergency gynecologic cases are for incomplete abortion. Access to safe technology for manual vacuum aspiration (MVA) is a major obstacle in reducing morbidity and mortality from unsafe abortion. A new policy has established MVA treatment and counseling services on a outpatient basis for all incomplete abortion patients with a uterine size of less than or equal to 12 weeks gestation at Harare Central Hospital and Parirenyatwa Hospital. This study reports on a pre/post evaluation of the safety and effectiveness of the MVA procedure compared to the traditional method of sharp curettage. Prior to the intervention, 589 out of 1000 consecutive incomplete abortion patients from 2 public hospitals in Harare were interviewed. 1 year after the intervention, 834 out of 1000 consecutive incomplete abortion patients treated with MVA were interviewed. Both groups had interviews within 2 weeks for follow-up visits. The results showed the MVA procedure to be safe and effective, and family planning (FP) acceptance was increased after introduction of FP counseling. Both populations were similar in age, parity and marital status to a prior study by Verkuyl and Crowther. Post procedure complications ere lower for the MVA procedure group. Only 6% of MVA patients versus all of the sharp curettage patients received pain control (analgesia or sedation). Provider assessment of pain during the procedure was found to be equal, but patients in the MVA group expressed quite a lot of pain, which had led to new procedures on pain control for the MVA group. Prior to intervention, only 46% of women treated for abortion complications accepted a FP method post procedure, but 97% accepted after the introduction of FP counselors and use was sustained at 2 weeks follow-up. The MVA procedure has the utility of being used in decentralized services, which would reduce the delay in obtaining services and contribute to better outcome. At present, abortion care is separate from maternal health and family planning services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 080000.Article de périodique
Bradley J.; Sikazwe N.; Healy J.
Improving abortion care in Zambia
1992 - Women's Global Network for Reproductive Rights Newsletter, 39), p. 30-33
Mots clés : loi; complication; aspiration; méthode; hôpital; hospitalisation; avortement; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé; programme
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Zambia, abortion has been legal for health and socioeconomic reasons since 1972, yet in 1982-83, 15% of all maternal deaths at the University Teaching Hospital (UTH) in Lusaka were attributed to illegally induced abortion. In late 1988, UTH's Department of Obstetrics ad Gynecology began a collaborative project with International Projects Assistance Services to improve the management of incomplete abortion and to increase the capacity for providing legal pregnancy terminations. The 3-year training and service delivery program used manual vacuum aspiration (MVA), according to WHO the method of choice for uterine evacuation. In the 2 years since the commencement of the program, MVA training and service delivery have become routine at the hospital for uterine evacuation up to 12 weeks. Before the introduction of MVA, 30-40 patients waited each day, usually for at least 12 hours for uterine evacuation, and only about 10 women actually were treated each day. Now, most women wait about 4-6 hours. After undergoing the MVA procedure in the treatment room with little or no sedation, most patients are discharged after 1-2 hours of observation. Since the introduction of MVA, the number of terminations at UTH has remained constant at between 55 and 59 per month, most of them during the 1st trimester. Between 1988 and 1990, the ratio of induced to incomplete abortions at the hospital has improved from 1:25 to 1:5. However, conditions in most other hospitals resemble those that characterized UTH's gynecology ward in 1988.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 077633.Article de périodique
Bazira E.R.
Induced abortion at Mulago Hospital Kampala, 1983 - 1987: a case for contraception and abortion laws' reform
1992 - Tropical Health, 11(1), p. 13-16
Mots clés : méthodologie; enquête; déterminant; complication; loi; demande; counseling; contraception; méthode contraceptive; hôpital; hospitalisation; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; facteur économique; clinique; hôpital; service de santé; programme; service de santé; soin; santé
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Uganda, university students interviewed 1180 abortion cases admitted to the gynecological emergency ward at New Mulago Hospital in Kampala during 1983-1987 to examine the magnitude of induced abortion at this referral/teaching hospital. Obvious induced abortions, probable induced abortions, and spontaneous abortions comprised 25.4% (300), 40.7% (480), and 33.9% (400), respectively. Further analysis was only conducted on the 300 induced abortion cases. All but 4% (12) of induced abortion cases were younger than 25. Adolescents comprised 67.7% of all induced abortion cases. No one over 34 had an induced abortion. Most induced abortion cases (79%) had never been married. Induced abortion was most common among students (49.7%) and single working women (30.3%) and least common among full-time housewives (5.7%). Induced abortion had a positive association with education (no schooling = 1.3%, primary = 2%, secondary = 53.7%, and university = 23.7%). Christians were more likely to undergo induced abortion than Moslems (43.3% for Protestants and 46.3% for Catholics vs. 10.3% for Moslems). Most of the induced abortion cases had been pregnant with their first pregnancy (57.3%). The main method of pregnancy termination was dilatation and curettage (53.3%). Physicians (91%) performed most of the induced, albeit illegal, abortions. 56.6% of induced abortion patients stayed in the hospital for no more than 13 days. Patients who stayed for more than two days had serious complications, including hemorrhage (39.7%), sepsis (21%), and genital perforation (15.3%). The main reasons the women sought an induced abortion were desire for more education (48.7%) and fear of parents (25.7%). The induced abortion related mortality rate was 3.3%. These induced abortion cases were probably faced with an unwanted pregnancy. Most knew about family planning, but had not used any of family planning methods. Liberalization of contraception and reform of the abortion law should occur to provide women family planning and legal, inexpensive, and safe abortion services.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 104596.Article de périodique
Baker J.; Khasiani S.A.
Induced abortion in Kenya: case histories
1992 - Studies in Family Planning, 23(1), p. 34-44
Mots clés : méthodologie; enquête; avortement; décision; soin post-abortum; mariage; ville; résidence; pauvreté; grossesse non prévue; grossesse non désirée; loi; collecte; contraception d'urgence; contraception postcoitale; planning familial; comportement; santé de la reproduction; état matrimonial; nuptialité; état matrimonial; mariage; famille; population; facteur démographique; facteur socio-économique; facteur économique; fécondité
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In October 1989, researchers conducted in-depth interviews with 20 men and women knowledgeable about induced abortion in Kenya and with 30 mostly urban, single, and low income women from Nairobi who had an abortion. They intended to examine induced abortion in Kenya, which is illegal except to save the mother's life, since prior research is limited to hospital data. The key informants revealed that induced abortion is relatively common, especially among single women. Further they said abortion related deaths occur often and that friends usually provide the abortion seeker with information. They recognized that abortion is a woman's issue. Abortion costs and services varied. For example, trained health practitioners in top rate health facilities charged the most money (KSh.10,000). The informants noted that nonhealth workers also induce abortions. Among the women who had an abortion, almost all had used contraceptives in the past and many stopped due to complications or side effects. In fact, some were using contraceptives when they became pregnant. Economic reasons tended to explain why these women underwent an abortion. 6 of the 30 had at least 1 previous abortion. Further, except for 8 cases, they decided alone to have an abortion. They tended to seek information about abortion services from a friend. The most common abortion procedure in a health facility was dilation and curettage and the most common procedure performed by an untrained practitioner, usually a male, was inserting a hollow tube into the cervix for several hours. 15 of the women reported complications, 3 of whom went to Kenyatta National Hospital. This study showed that contraceptive failure and discontinuation contributed greatly to induced abortion. It also revealed that contraceptive practices did not effectively reach young, single, urban women.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 071421.Article de périodique
Gerais A.S.; Rushwan H.
Infertility in Africa
1992 - Population Sciences, 12(25-46
Mots clés : stérilité; prévalence; complication; maladie sexuellement transmissible; MST; IST; santé de la reproduction; mesure; méthodologie; contraception d'urgence; contraception postcoitale; planning familial; IST; MST; infection; complication; maladie; complication
Pays / Régions : AfriqueRésumé : Infertility is of particular concern in Africa because of the extent of the problem and the social stigma attached to it. The highest prevalence of infertility in Africa occurs south of the Sahara, but 5-8% of couples are estimated to experience infertility at some point in their reproductive lives (50-80 million people worldwide). The average infertility in Africa is 10.1% of couples, with a high of 32% in some countries, and certain tribes have high infertility rates. While primary infertility is higher in other regions of the world, secondary infertility is more common in Africa, and secondary infertility rates are very complicated to determine. The World Health Organization Task Force on the Diagnosis and Treatment of Infertility instituted a standardized approach to studies of infertility which was adopted in 33 countries. Between 1978 and 1982, a pilot study of this approach examined 8504 couples and found that less than 50% of male and female infertile partners were primarily infertile, and 66% did achieve a pregnancy within the union. The cause of infertility was not determined for 35% of the women and 50% of the infertile men in the sample. Infertility was accounted for by endocrine factors (usually menstrual or ovulatory disturbances) in 35% of infertile cases and tubal factors (such as unilateral or bilateral tubal occlusion, pelvic adhesion, and other abnormalities) in 32%. About 66% of African women experienced tubal factors compared to about 33% worldwide. About 9% of women reported a history of sexually transmitted disease (STD), and 8% reported abortion complications. 46% of men in sub-Saharan Africa reported a history of STDs. About 24% of women with primary infertility and 40% of women with secondary infertility had no previous history of pelvic inflammatory disease or STDs and had tubal disease. African infections are common due to inadequate health services, improper use of antibiotics, and penicillin-resistant strains of gonorrhea. Public health programs should be implemented to prevent infection-related infertility.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 099086.Congrès
Catteau C.
Interruption volontaire de grossesse à la Réunion
1992 - Fécondité et insularité. Publication intégraleColloque International Fécondité et Insularité, Saint-Denis (RE) 1992/05/11-15, Saint-Denis (RE), Conseil Général de la Réunion, p. 1027-1042 p.
Source : Source Ceped : http://ceped.cirad.fr.Congrès
Combes J.C.
Interruption volontaire de grossesse chez les mineures à la Réunion
1992 - Fécondité et insularité. Publication intégraleColloque International Fécondité et Insularité, Saint-Denis (RE) 1992/05/11-15, Saint-Denis (RE), Conseil Général de la Réunion, p. 1043-1048 p.
Mots clés : adolescence; adolescent
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Toure B.; Thonneau P.; Cantrell P.; Barry T.M.; Ngo Khac T.; Papiernik E.
Level and Causes of Maternal Mortality in Guinea West Africa
1992 - International Journal of Gynecology Obstetrics, 37(2), p. 89-96Résumé : GUINEA ; METHODOLOGICAL STUDIES ; DEMOGRAPHIC SURVEYS ; COMMUNITY SURVEYS ; BIRTH RECORDS ; DEATH RECORDS ; MATERNAL MORTALITY ; CAUSES OF DEATH ; ABORTION, INDUCED ; HYPERTENSION ; BLEEDING ; POSTPARTUM WOMEN ; HOSPITALS ; PRENATAL CARE ; URBAN POPULATION [WOMEN] ; Western Africa ; Africa South of The Sahara ; Africa ; French Speaking Africa ; Developing Countries ; Population Dynamics ; Demographic Factors ; Population ; Surveys ; Sampling Studies ; Studies ; Research Methodology ; Vital Statistics ; Population Statistics ; Mortality ; Fertility Control, Postconception ; Family Planning ; Vascular Diseases ; Diseases ; Signs and Symptoms ; Puerperium ; Reproduction ; Health Facilities ; Delivery of Health Care ; Health ; Maternal Health Services ; Maternal-Child Health Services ; Primary Health Care ; Health Services ; Population Characteristics
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 071470.Article de périodique
Toulemon L.; Leridon H.
Maîtrise de la fecondité et appartenance sociale: contraception, grossesses accidentelles et avortements
1992 - Population, 47(1), p. 1-46Résumé : In France, the contraceptive use of 2077 women aged 20-45 in 1978 and 1773 women of the same age in 1988 was compared by applying a regression logistic method. In the 1988 sample contraceptive prevalence reached 68%. 3 out of 4 women aged 20-24 used the pill compared with 1 out of 4 in the 40-44 age group. 44% of pill users and 49% of other method users wanted to have a child eventually. Women over 40 used withdrawal, the condom, and other methods more than younger women. 67% consulted a doctor for contraceptive advice in 1978 vs. 92% in 1988. Pill use increased from 37% to 46% and IUD use from 12% to 27%, respectively. Among nulliparas pill use increased from 37% to 56%, while it decreased among unmarried women from 58% to 47%. Pill use varied from 33% in agricultural occupation to 56% among employees. 281 women considered religion a very important factor in using a contraceptive in 1978, but only 182 in 1988. 86% thought that they made a good choice of contraception in 1978 vs. 92% in 1988; 70% did not fear accidental pregnancy in 1978 vs. 69% in 1988; 23% in 1978 would choose abortion in case of pregnancy vs. 26% in 1988; and 17% envisioned switching methods vs. 11%, respectively. 37% of women did and 28% did not want to keep the child in 1988. 20% of pill users and 29% of IUD users feared pregnancy whose risk varied from 2% for the 1st year of pill use to 12% for the withdrawal method. Women who admitted having more abortions also had more children when taking age and marital status into consideration. Access to different methods of contraception affects motivation to use a method more than the law on birth control, and the doctrine of the Catholic Church about abortion influenced believers.
Source : source Population : http://www.ined.fr/publications/population/index.html.Article de périodique
Chiphangwi J.D.; Zamaere T.P.; Graham W.J.; Duncan B.; Kenyon T.; Chinyama R.
Maternal mortality in the Thyolo district of southern Malawi
1992 - East African Medical Journal, 69(12), p. 675-679
Mots clés : méthodologie; enquête; mortalité maternelle; risque; programme; décès; complication; avortement; mortalité; étudiant; scolarisation; population; facteur démographique; facteur économique; facteur géographique; maladie; complication; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Malawi; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In September 1989 in Thyolo district in southern Malawi, 5 field teams used the Sisterhood Method to interview 4124 people older than 15 in 7 traditional authorities to estimate the lifetime risk (LTR) of maternal death and the maternal mortality ratio (MMR) in this area. The teams also administered an in-depth questionnaire to respondents who knew about 140 of the 150 maternal deaths to determine the causes of maternal death. The LTR of maternal death stood at 1 in 36 (1/.0282). The MMR was 409/100,000 live births. 22% of all maternal deaths occurred within the last 5 years. The field team was able to accurately determine the cause of death in 98 (65%) cases. The leading causes of death were excess hemorrhaging (25%), obstructed labor (20%), abortion (18%), sepsis (13%), cesarean section (7%), and eclampsia (4%). 56% of all reported maternal deaths and 45% of maternal deaths within the last 5 years occurred outside a health facility. 99% of maternal death cases did not receive medical attention while their health deteriorated because the health facility was far away and therefore not accessible or there was no way to transport the women to the health facility. 87% of abortion-related deaths took place outside a health facility as did 67% of eclampsia cases, 56% of hemorrhage cases, 50% of obstructed labor cases, and 47% of sepsis cases. These findings should prove useful to community and health leaders in designing intervention strategies to reduce maternal mortality in the area. Further, key locations should have adequate transportation, e.g., bicycle ambulances of stretchers, to transport pregnant women to a primary or referral center.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 083989.Article de périodique
Agyei W.K.; Epema E.J.
Sexual behavior and contraceptive use among 15-24-year-olds in Uganda
1992 - International Family Planning Perspectives, 18(1), p. 13-17
Mots clés : contraception; méthode contraceptive; sexualité; adolescence; adolescent
Pays / Régions : OugandaRésumé : Based on the findings of the Ugandan Adolescent Fertility Survey, sexual behavior and contraceptive use among young adults aged 15-24 in both rural and urban Uganda were examined. The survey consisted of 2 phases which took place on August through October 1988 and August and September 1989. The data from 4510 eligible respondents were analyzed. A description of the social and demographic characteristics of the respondents is provided. As the survey data reveal, sexual activity begins at an early age in Uganda. At the time of the survey, 85% of the male sample and 81% of the female sample were sexually experienced. The mean age at first coitus was 15.1 among sexually experienced males and 15.5 among sexually experienced females. The survey also found that nearly 1/2 of all female respondents had ever been pregnant (11% were pregnant at the time of the survey). While 34% of women in small urban centers reported ever being pregnant, the ratio was 61% for rural young women. Of the women who had ever been pregnant, 14% reported having an abortion. Since Uganda allows abortion only for medical reasons, it is suggested that in reality abortion is far more common. Awareness of contraceptive methods was over 80% for both males and females, but fewer than 25% of the sexually active respondents who desired no children actually used contraception. Contraceptive prevalence was significantly lower in rural areas. lack of access to contraception led the reasons for nonuse of contraception, followed by safety concerns and lack of knowledge. These findings suggest the need to make contraceptive service delivery available to adolescents in all parts of the country.
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/.Article de périodique
Mahomed K.; Chawapiwa A.
Socio-demographic characteristics of women presenting with abortion: A hospital based study
1992 - Central African Journal of Medicine, 38(6), p. 233-237
Pays / Régions : ZimbabweRésumé : Objective: To determine socio-demographic characteristics and clinical features of women presenting with abortion, and to define factors associated with complications of abortion. Design: A prospective descriptive study. Setting: Women in Gynaecology casualty department at Harare Central Hospital, Harare, Zimbabwe. Patients: 307 women with features of complete or incomplete abortion were interviewed during February to June 1991. They were randomly selected and represented 53pc of all women with the problem. Results: Three quarter of the women were married and lived with their spouses. In 23.1pc this was a first pregnancy. Over a quarter of the women who were on the pill claimed to have fallen pregnant whilst on the pill, mainly because of poor compliance. One hundred and twenty-two were not on the pill but in only 16pc it was intended to fall pregnant. In nearly 30pc the pregnancy was not wanted but only 2.3pc admitted to having induced the abortion. Sepsis was present in 25.6pc and they tended to be younger, not presently married and have an unplanned pregnancy. Although there was some evidence of trauma in 6.2pc, it was not possible from the study to assess the percentage of abortion likely to have been induced. Conclusion: Contraceptive usage is generally low and cultural and traditional factors may play a role, but expanded sex education programmes and continued contraceptive counselling need reinforcing before attempts are made to review the legal issues regarding termination.
Source : source : Central African Journal of Medicine.Article de périodique
Nash E.S.; Navias M.
The therapeutic sterilisation of the mentally handicapped: Experience with the Abortion and Sterilisation Act of 1975
1992 - SAMJ (South African Medical Journal), 82(6), p. 437-440
Mots clés : stérilisation; contraception; législation; décision; droit; éthique; psychologie; facteur psychologique; comportement; planning familial
Pays / Régions : Afrique du Sud; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The Abortion and Sterilization Act of 1975 gives legal sanction for the sterilization of persons with a mental handicap, and by 1989, 1817 such persons had been sterilized in South Africa. In this paper, the authors review their experience in investigating all 291 persons who were referred to the Pregnancy Advisory Service of Groote Schuur Hospital for this purpose. Referrals included 37 white, 233 colored, and 21 black patients. 108 (37.1%) were severely retarded, 104 (35.7%) were moderately retarded. 70 (24%) were mildly retarded, and 9 (3.2%) were not testable. None could give informed consent and the applications for sterilization came from burdened families of whom one third were already caring for illegitimate children born to these mentally handicapped women. Of the 291 applications, 231 (79%) were recommended for sterilization. The main issues involved in making a decision to sterilize mentally retarded individuals are the valid assessment of the degree of retardation, the availability of alternative means of fertility control, and the complex ethical factors that have to be considered with regard to the sterilization of persons with a mental handicap. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 081715.Article de périodique
Adewole I.F.
Trends in postabortal mortality and morbidity in Ibadan, Nigeria
1992 - International Journal of Gynecology and Obstetrics, 38(2), p. 115-118
Mots clés : méthodologie; loi; complication; mortalité; hôpital; hospitalisation; personnel de santé; soin; avortement; contraception d'urgence; contraception postcoitale; planning familial; population; facteur démographique; service de santé; santé; complication grossesse; maladie; complication; éducation
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : All of the 4448 abortion cases managed at the University College Hospital, Ibadan, Nigeria, between 1980-89 were assessed. Abortion is illegal in Nigeria and carries with it a penalty of 14 years imprisonment, but physicians and nonphysicians operate without prosecution, unless complications are severe. Information was obtained from hospital case records in the emergency unit, the gynecology ward, and operating room. Data included information on demography, type of abortion, pattern of morbidity, mortality, duration of hospital stay, cost of management, and qualifications and training of the physician or provider. Abortion is any interruption before a fetus has viability, which is considered as a birthweight of 500 g or less and 26 weeks' gestation. 840 of 912 cases judged to have been illegally induced and with a complete information were analyzed. The number of cases rose from 43 in 1980 to 164 in 1989. Fatality varied. 79.1% were aged 15-29 years. 57.9% were single, 39.8% were married, and 2/4% were divorced. 54.7% (460) were unemployed, housewives, or students and 37.6% were unskilled workers. 76.2% were nonusers of contraceptives and 21% were contraceptive users. Among abortions performed, 42.8% (360) were done by untrained persons, 6.4% by nurses, and 21% by chemists. 29.8% were performed by physicians, who were responsible for 66.7% of fatalities in 1989. Lack of adequate training might be responsible for the poor response. 7.4% had a hospital stay longer than 2 weeks, while 13.3% were released within 3 days. The bulk of patients were hospitalized for 3-7 days (38.3%) or 7-14 days (41%). The usual cost of hospital care was N350 or US $35, an amount in excess of the national monthly minimum wage. 13.1% spent N1000. Complications of illegally induced abortions involved sepsis in 86.2% of cases and hemorrhage in 35.2%. 25.7% had injuries to the uterus, bowel, and lower genital tract. It is felt that abortion rates reflect unwanted pregnancy and are an indicator of the urgent need for fertility control services. The danger posed by illegal abortions would be eliminated by liberalization of abortion law and increased acceptance of family planning. The findings of 20.5% illegal abortions among abortions performed is close to the estimates of 28.4% with 46% complications. As well as other legal and educational actions, family planning services need to be made available.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 073535.
1990Article de périodique
Magadi M.A.; Kuyoh M.A.
Abortion: attitude of medical personnel in Nairobi, Kenya
1991
Mots clés : méthodologie; enquête; avortement; loi; connaissance, attitude; pratique; CAP; médecin; personnel de santé; infirmier; personnel de santé; soin post-abortum; counseling; étudiant; scolarisation; contraception d'urgence; contraception postcoitale; planning familial; attitude; psychologie; facteur psychologique; comportement; personnel de santé; soin; santé; programme planning familial; clinique; hôpital; service de santé; programme
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Researchers randomly distributed self administered questionnaires to 105 physicians, 29 clinical officers, and 137 nurses in Nairobi, Kenya to examine their attitude towards abortion. Medical personnel, especially clinical officers and nurses, knew little about abortion indicating poor information dissemination or insufficient interest. The leading clinical procedures included dilation and curettage, vacuum suction, and use of prostaglandins. The major nonclinical methods in order were traditional herbs, sharp instruments, and malariaquin/chloroquine overdose. Respondents agreed that nonclinical methods posed the greatest risk to life. 56% reported that a close friend or relative had asked them for an abortion. Most suggested that she not terminate her pregnancy or go to a qualified physician for the abortion. Only 1% said they performed an abortion for a close friend or relative. Most of the respondents felt that an abortion should be performed only when the pregnancy poses a danger to the mother's life, when the fetus may be deformed, or in cases of rape. Moreover they believed that abortion should continue being illegal, except in cases where the mother's life is in jeopardy. Physicians had a more positive attitude towards abortion than clinical officers and nurses. Further single/divorced/separated, noncatholic younger respondents with <3 children tended to have a positive attitude whereas older, married, Catholic respondents with >3 children had a negative attitude. In addition, those in the private sector had a more positive than those in the public sector. Obstetrician/gynecologists and surgeons tended to be more negative than pediatricians and other physicians. Nevertheless essentially all physicians believed postabortal counseling to be important, especially if the sessions emphasized abortion risks and effective contraceptive use.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 067909.Article de périodique
Ojwang S.B.; Maggwa A.B.
Adolescent sexuality in Kenya
1991 - East African Medical Journal, 68(2), p. 74-80
Mots clés : revue littérature; sexualité; partenaire; sexualité premaritale; maladie sexuellement transmissible; MST; IST; déscolarisation; scolarisation; facteur économique; école; scolarisation; contraception; méthode contraceptive; loi; service de santé; adolescence; adolescent; fécondité; grossesse adolescente; grossesse; menstruation; famille; sexualité; grossesse non prévue; grossesse non désirée; comportement; IST; MST; infection; complication; maladie; complication; éducation; facteur socio-économique; école; scolarisation; planning familial; avortement; contraception d'urgence; contraception postcoitale; soin de santé primaire; soin; santé; jeune; adolescent; âge; population; facteur démographique; taux fécondité; taux natalité; santé de la reproduction
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Kenya's population has increased from 5.4 million in 1948 to 15.3 million in 1979 and is expected to rise to 39 million by 2000. The population growth rate has risen from 2.5% in 1948 to 3.8% in 1979. Improvements in health and economic status since independence have caused significant changes from 1948-79: the fertility rate of women has increased from 6.5-7.9, the crude death rate has decreased from 25/1000-14/1000, infant mortality has decreased from 184/1000-104/1000 births, and life expectancy has increased from 35-54 years. Adolescent girls, 15-24, contribute up to 30% of total pregnancies of females, 15-49, and will form 44.2% of the reproductive age group by 2000. Between 1960 and 1979 the fertility rate of girls 15-19 has increased from 141/1000-168/1000. The age of menarche has dropped from 17 to 12-15. In 1 rural community 41.9% of the girls and 76.1% of the boys aged 12-23 had at least one sexual experience. The mean age at first coitus was 13.7 for boys and 14.9 for girls. 42% of the girls and 74.8% of the boys had more than one sexual partner. Because of the gradual change from extended families to nuclear families, education, role models, and any established activities that initiated youth into adulthood have virtually disappeared, leaving adolescents uneducated and unprepared. Only 2-6% use any form of contraception. 58.4% of rural and 64.4% of urban pregnant girls are in primary school at the time of conception. 8340-10,400 girls drop out of school due to pregnancy each year. 46.6% of girls who get pregnant are not married. Abortions among the adolescents account for 28-64% of abortions done in hospitals, but because of strict abortion laws in Kenya, most adolescents resort to criminal abortions frequently performed by inexperienced people in unsanitary conditions. Sexually transmitted diseases (STDs) are not uncommon among adolescents: 36.8% of pregnant adolescent females had at least 1 STD, compared to 16% of those aged 25 and above. Contraceptive services, education, and laws protecting the adolescent must be instituted in response to the problems of adolescent
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 067516.Article de périodique
Ahonsi B.A.
Components of stably high fertility in three areas of West Africa
1991 - Social Science Medicine, 33(7), p. 849-857
Mots clés : fécondité; nuptialité; état matrimonial; mariageRésumé : The constancy of fertility levels in Ghana, Senegal and southwest Nigeria since 1970 is separated into its nuptiality and marital fertility elements. The age-specific changes in the two components are examined and these show that the apparent stability in observed total fertility rates is essentially the outcome of the offsetting impact of increased marital fertility below age 25 and above age 40, over the effect of the increasing proportion of women remaining single up to 25 yr of age. Continuity in traditional fertility behaviour and stable nuptiality has remained operative over the broad middle segment of the reproductive lifespan of women in the three areas. The paper thus concludes that West Africa is likely to continue to display stably high fertility for many years into the next century. The social and cultural conditions behind this trend are discussed with special reference to the continued high demand for children and the low and only slowly rising contraceptive prevalence level.
Source : Source : Social Science Medicine.Article de périodique
Ladjali M.
Conception, contraception: do Algerian women really have a choice?
1991 - 125-141
Mots clés : planning familial; déterminant contraception; sexualité; déterminant fécondité; service de santé; programme; demande; sage-femme; personnel de santé; soin de santé primaire; communauté; éducation; IEC; information éducation communication; loi; famille; culture; genre; psychologie; facteur psychologique; comportement; fécondité; population; facteur démographique; soin; santé; facteur économique; personnel de santé; avortement; contraception d'urgence; contraception postcoitale
Pays / Régions : Algérie; France; Afrique Francophone; Afrique; Afrique du Nord; Pays arabes; Pays Méditerranéens; Europe de l'Ouest; EuropeRésumé : In Algeria, some women do not use contraception because they, their husbands and their in-laws consider it a sin or state interference in family affairs. Women sometimes reject family planning because children are the only means of achieving respect in their husbands' families with whom they live. They may not use contraception until they have several sons. Often women want to use contraception, but their husbands refuse, thinking it would hurt their social image. Information diffusion campaigns that consider women's social realities may increase the practice of family planning such as what occurred in Algeria. Some of these realities include segregation of men and women, discussion of sexual matters only within same sex groups, uneasiness about sexuality, and ongoing transformation of women's lives (e.g., increased access to income and education). The Algerian maternal and child health/family planning (MCH/FP) program has retrained midwives to listen and respond to women. It has also conducted a study of the quality of MCH/FP care and an operations research study. It realizes the importance of having women participate in primary health care. The MCH/FP program plans to integrate literacy projects into its clinics. It wants women to feel comfortable rather than feel guilty for not following appropriate health and family planning guidelines at MCH/FP clinics. Clinics must value positive traditional practices. The MCH/FP program has examined the demand for family planning and the key role motivation plays in fertility and contraception. Abortion and adoption are illegal in Algeria, so if a single woman conceives, her only choice is to deliver away from her family and to abandon the infant at an orphanage. Since Algeria and France are historically linked, many Algerian women live in France where a different culture exists and permits certain behaviors not accepted in Algeria. This situation makes life confusing and difficult for these women.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 079612.Article de périodique
Ojwang S.B.; Omuga B.
Contraceptive use among women admitted with abortion in Nairobi
1991 - East African Medical Journal, 68(3), p. 197-203
Mots clés : contraception; méthode contraceptive
Pays / Régions : KenyaRésumé : A study of 519 consecutive women admitted to Kenyatta National Hospital with the diagnosis of abortion revealed that the majority were young and had a history of nonuse of contraception. Abortion was incomplete in 428 (83%) of cases; 60 (12%) cases involved sepsis. Women 20-24 years of age accounted for 221 (43%) of the abortions; the other two most represented age groups were 25-29 years (28%) and 14-19 years (17%). 460 (89%) of the abortion patients had never used a contraceptive method. The most frequently cited reasons for nonuse were desire for pregnancy (48%), no conscious reason (13%), procrastination in getting to a family planning clinic (8%), no knowledge of family planning (6%), and fear of side effects (6%). Of the 64 cases of failed contraception, 27 were using the pill, 25 had an IUD in place, and 8 were relying on the rhythm method. Among contraceptive users, the major sources of information about contraception were nurses (52%), radio and newspapers (19%), and other women (15%). Only 4% indicated that a physician had discussed family planning with them. Given the resource drain that treatment of incomplete abortion can place on Kenya's health care system and the risk of abortion-induced pelvic infection and subsequent infertility, Kenya's health workers should be encouraged to be more aggressive in promoting family planning use among young women.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 067121.Congrès
Gohy G. E.
Crise de l'emploi et stratégies de survie au Bénin : les diplômés du corps médical sans emploi face aux avortements provoqués clandestins
1991 - Journées Démographiques de l'ORSTOM, 4, Paris (FR) 1991/09/18-19, Paris (FR), ORSTOM, 16 + 12 p. multigr. p.
Mots clés : éducation
Pays / Régions : BéninRésumé : Affirmer que le système éducatif béninois est en crise est une banalité: l'année blanche connue en 1988-1989, les grèves estudiantines et les fermetures périodiques de campus enregistrées depuis quelque temps l'attestent. Ce qui l'est moins, ce sont les réponses individuelles et collectives mises en exergue dans les stratégies déployées par cette catégorie de scolarisés en milieu urbain qu'est le corps médical sans emploi. Il s'aqit de jeunes médecins, infirmiers et sages-femmes qui, après l'obtention de leur dip1ôme professionnel, ne sont pas intégrés dans la fonction publique béninoise, comme cela se faisait. L'objet de cette communication est de présenter les stratégies de survie (assez originales) qu'ils ont mises en place, les dynamiques familiales et sociales qu'elles ont engendrées et les logiques individuelles et collectives qu'elles permettent d'envisager. Il s'agit pour ainsi dire, d'une amorce d'interprétation dynamique des conséquences issues de la crise économique dont un corollaire i8p0rtant est la crise de l'emploi au Bénin.
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Singh S.; Deidre W.
Estimating abortion levels in Brazil, Colombia and Peru, Using hospital admissions and fertility survey data
1991 - International Family Planning Perspectives, 17(1), p. 8-13Résumé : Although abortion is illegal in every Latin American country except Cuba, induced abortion is being widely practiced throughout the region. Health planners need reasonable estimates of the prevalence of this practice. A methodology is provided for estimating the numbers of illegal abortions being performed, based primarily on the numbers of abortion complications treated in hospitals. Estimates of the number of induced abortions and the ratio of abortions to births for Peru, Brazil and Colombia indicate that for every 10 women giving birth, 3-4 in Colombia and Brazil and two in Peru terminate their pregnancies." (SUMMARY IN FRE AND SPA) (EXCERPT)
Source : Reproduced with the permission of The Alan Guttmacher Institute : http://www.agi-usa.org/.Article de périodique
Mhloyi M.M.
Fertility transition in Zimbabwe
1991
Mots clés : méthodologie; déterminant fécondité; facteur socio-économique; histoire; nuptialité; état matrimonial; mariage; allaitement; contraception; méthode contraceptive; prévalence contraceptive; stérilité; taux; mariage; état matrimonial; éducation; taille famille; fécondité; population; facteur démographique; facteur économique; politique; psychologie; facteur psychologique; planning familial; santé de la reproduction; avortement; contraception d'urgence; contraception postcoitale; santé; évaluation; famille
Pays / Régions : Zimbabwe; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Data from the Reproductive Health Survey of 1984-1985 and the Demographic Health Survey of 1987-88 in Zimbabwe are analyzed in order to understand the determinants of fertility decline from 6.6 to 5.31. The demographic and socioeconomic context is described for the colonial and postcolonial periods. Fertility is plotted between 1969-88. the contribution of proximate variables (nuptiality, contraception, and lactation) to fertility decline is discussed. Because contraceptive prevalence is high, it is reasoned that the decline in fertility between 1984-88 is due to factors in addition to contraception. Bongaarts's model is used to assess the contribution of 4 intermediate variables (marriage, contraception, abortion, and postpartum infecundability) to the decline in fertility. The results show that fertility is explained principally through nuptiality patterns and contraception, which increased 8% and 5%, respectively, between 1984-88. Breast feeding ceases to be as important as a country exerts greater controls on fertility. The delay in age of entry into marriage and the ease of marriage disruption have been facilitated by improvements in education and the change in regulations on divorce, child custody, and maintenance. The consequence is a negative effect on the duration of exposure to the risk of childbearing. The costs of children have increased and have led to the need to space births more efficiently. Contraceptive impact was due to the use of more efficient methods rather than an increase in methods, particularly among the none educated. There were increases among the rural and none educated, which reflects changes in contextual variables such as family size desires and family planning program effort. From qualitative data, it is learned that parents know about the declines in mortality and the increased cost of raising educated children. There is a reduction in benefit of children to parents. Further declines are expected because of the desire for smaller family sizes. While education operated through delayed age at marriage, in the future education will affect contraception as the educated cohort enters reproductive ages. Economic prospects are not hopeful, which further pressures families to reduce family size.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 074171.Article de périodique
McLaurin K.E.; Hord C.E.; Wolf M.
Health systems' role in abortion care: the need for a pro-active approach
1991
Mots clés : avortement; complication; demande; soin post-abortum; mortalité maternelle; service de santé; loi; programme planning familial; offre contraception; régulation menstruelle; aspiration; méthode; curetage; méthode; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; facteur économique; mortalité; population; facteur démographique; soin de santé primaire; soin; santé; contraception; méthode contraceptive; intervention chirurgicale; méthode; intervention chirurgicale; traitement; soin
Pays / Régions : Bangladesh; Nicaragua; Nigeria; Turquie; Zambie; Roumanie; Asie du Sud; Asie; Amérique centrale; Amérique du Nord; Amérique; Amérique Latine; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique Anglophone; Moyen Orient; Pays Méditerranéens; Afrique de l'Est; Europe de l'Est; EuropeRésumé : Abortion is illegal in many countries, yet health systems in every country do provide emergency treatment for abortion complications. Nearly every country allows abortion in cases of rape, incest, and/or risk to the mother's life. Health systems in a country where abortion is illegal neither admit the magnitude of the need for abortion related care not plan legally indicated services effectively. Thus nearly 200,000 women die annually from complications of unsafe abortion and many more face serious injuries. 99% of the deaths and injuries happen in developing countries. A proactive approach by the health systems, even within their present legal framework, would improve the quality and effectiveness of current abortion care. 1st they must acknowledge the problem of unsafe abortion. They then need to integrate abortion care into the comprehensive reproductive health care system. Most importantly, they must decentralize both preventive and curative services. Nigeria, Nicaragua and Bangladesh have been able to provide needed abortion care, despite the restricted legal environment. Nigeria now trains medical students in manual vacuum aspiration (MVA) to treat incomplete and septic abortions which has fewer complications than does dilation and curettage (DC). Nigeria also added family planning counseling and services to women undergoing MVA. Nicaragua changed its penal code to allow therapeutic abortion to not only save the mother's life, but also in cases of rape or incest and if the fetus is severely abnormal. Like Nigeria, Nicaragua also replaced DC with MVA. Bangladesh promotes menstrual regulation, despite restrictions on abortion. Romania, Turkey, and Zambia are examples of countries that liberalized their abortion laws resulting in reduced maternal deaths.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 067912.Article de périodique
Bradley J.; Nsama S.; oan H.
Improving abortion care in Zambia
1991 - Studies in Family Planning, 22(6), p. 391-394Résumé : In this commentary, the impact of the introduction of manual vacuum aspiration (MVA) for incomplete abortion patients and for early uterine evacuation is discussed for the University Teaching Hospital in Lusaka, Zambia. This 3-year training and service delivery program was begun in 1988 after it was clear that 15% of maternal deaths were due to illegally induced abortion. The prior procedure of dilation and curettage (D and C) required use of the main operating room and general anesthesia, which resulted in severe congestion and treatment delays. As a result of the new MVA procedure, congestion has decreased substantially, treatment is safer and more timely, and the staff's ability to provide abortions has increased. Family planning counseling is provided to postabortion patients in a more thorough fashion, and the savings in time has improved the quality of patient-staff interactions. Specifically, the patient flow has improved from a 12-hour wait to a 4-6 hour wait and rarely requires overnight hospitalization. The demand for the main operating room had decreased which frees space, time, and commodities for other gynecological treatment. The shorter procedure and release time means a minimal loss of earnings and productivity, and allows for greater privacy in explaining absences to families, schools, or employers. The improved quality of are is reflected in the figures for number treated, i.e., in 1989, 74% were treated with MVA for incomplete abortion <12 weeks and pregnancy termination <8 weeks compared with 26% treated with D and C. In 1990, the figures were 86% with MVA and 14% with D and C. The likelihood of complications from hemorrhage and sepsis have also been reduced. The MVA procedure is also less traumatic for the patient. The increased access to safe legal abortion services is reflected in the ratio of induced to incomplete abortions between 1988-1990 (1:25 to 1:5). Family planning counseling is provided by a full-time counselor who counsels preabortion and postabortion and schedules 2-week follow-up appointment. These achievements have been made in spite of a declining economy and difficulties in the health sector. Unfortunately, conditions throughout Zambia are such that access to safe abortion is restricted. Effort is underway to expand this MVA training and service delivery in provincial hospitals and to conduct research on other effective strategies to reduced unsafe abortion and improve family planning care.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 070376.Article de périodique
Kampikaho A.; Irwig L.M.
Incidence and causes of maternal mortality in five Kampala hospitals, 1980-1986
1991 - East African Medical Journal, 68(8), p. 624-631
Mots clés : méthodologie; hôpital; hospitalisation; mortalité maternelle; décès; complication; programme; service de santé; soin; santé; mortalité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; soin de santé primaire
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Maternal mortality is examined from June 1980 to December 1986 at Mulago, Nsambyo, Old Kampala, Rubaga, and Mengo Hospitals in Kampala, Uganda. Clinical or immediate causes, direct and indirect, were recorded from case summary forms based on ICD9 definitions of obstetric complications. The nonabortion maternal mortality rate (NAMMR) was 2.65/1000 deliveries (580 deaths); the abortion-related maternal mortality rate (ARMMR) was 3.58/1000 abortions. The hospital maternal mortality rate was 2.0/1000 deliveries. 75% of maternal deaths of women of 28 weeks' gestation or more had delivered outside the hospital. NAMMR doubled between 1980-86, a statistically significant increase. ARMMR increases were almost significant. 75% were direct obstetric and 21% were indirect obstetric causes. 38% had clinical anemia, 29% had some sepsis, 18% had substantial bleeding, and 14% had obstructed labor. Other contributing conditions were pneumonia, ruptured uterus, laparotomy, evacuations and curettage, malaria, preeclampsia, sickle cell anemia, pulmonary embolism, malnutrition, tetanus, meningitis, prolonged labor, and hepatitis. At admission, 48% were in poor condition, 30% in good condition, and 22% in fair condition. 27% had sickle cell anemia, high blood pressure, multiple pregnancy, or malaria at admission. 64% were admitted within 24 hours after delivery, 67% 1-7 days after delivery, and 92% 7-42 days after delivery. Those in good condition were all admitted <7 days postdelivery. 41% of deaths were due to lack of drugs, 7% lack of fluids, 20% with theater problems, 14% with doctor-related factors, and 3% with midwife-related factors. Better information is needed on mortality before delivery, mortality in hospitals vs. outside, and mortality from abortion, and ectopic and hydatidiform molar pregnancies. An explanation given for the increase in maternal mortality is the decline in economic conditions. Abortion complications may be due to the concealment practiced. Causes are consistent with trends from the 1950s, 1960s, and 1970s in Uganda and developing countries in general. Availability and accessibility of gynecological and obstetric services needs great improvement. Training traditional birth attendants and obtaining rural ambulance services are also needed. Health workers lack creativity and imagination for developing country conditions; scarce resources are not the only problem.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 070340.Rapport
Rogo K.O.
Induced abortion in sub-saharan Africa
1991 - Department of obstetrics and gynaecology, Nairobi, 31
Source : Source : Ceped.Thèse
Koly F.
L'avortement provoqué clandestin : aspects actuels et perspectives à la clinique gynécologique et obstétricale du CHU de Dakar
1991 - Faculté de Médecine, Dakar, 117Résumé : La thèse de F. Koly porte sur l'étude des avortements provoqués clandestins (APC) recensés à la clinique gynécologique et obstétricale (CGO) du CHU de Dakar de février 1988 à décembre 1989. L'approche méthodologique développée par Koly lui a permis de recenser les cas d'APC avérés et compliqués survenus au CHU de Dakar de février 1988 à décembre 1989. Les cas d'APC probables, possibles et les avortements spontanés et thérapeutiques n'ont pas été pris en compte dans cette recherche. Koly a également identifié un certain nombre de limites de son enquête liées au fait que le CHU accueille surtout les indigentes et les cas d'APC graves. Il en résulte donc un biais de sélection de la population cible. A propos de l'ampleur du phénomène, Koly a recensé 133 cas d'APC sur: 12.729 accouchements, 2020 avortements et 152 décès maternels de février 1988 à décembre 1989. Les résultats de sa thèse révèlent que l'incidence des APC est de : - 1,04 % rapportée aux accouchements, - 6,58 % rapportée aux avortements, - 1,31 % rapportée aux décès maternels. Koly a également analysé le profil des femmes concernées par l'APC. Il ressort de son analyse que les femmes les plus exposées au risque d'APC sont âgées de 20 à 24 ans, célibataires, sans enfant vivant et sans profession. Elles résident souvent dans la banlieue de Dakar et n'ont pas utilisé une méthode contraceptive au cours des derniers mois précédant l'avortement. La thèse de Koly révèle la prédominance des facteurs socio-économiques au niveau des motifs évoqués par les femmes concernées par l'APC : la crainte des parents dans 21,06 % des cas ; la peur des critiques de l'entourage (pour 20,30 % des femmes); le refus de maternité pour des raisons personnelles selon 25,56 % des cas ; l'insuffisance des moyens financiers (pour 13,53 % des femmes); l'impact négatif de la grossesse sur les études selon 17,29 % des cas. Koly s'est également intéressé aux déterminants médicaux et au coût de l'APC. A ce propos, il démontre que la manoeuvre abortive s'opère souvent avec la complicité d'un paramédical pour 10.000 à 20.000 F CFA. Il estime le coût de la prise en charge des complications de l' APC à 5.272 F CFA par jour. La thèse de Koly porte aussi sur l'étude des risques médicaux liés aux APC et sur leur prise en charge thérapeutique. Il apparaît ainsi que les complications de l'APC sont essentiellement hémorragiques et que les soins médicaux et obstétricaux associés durant six jours permettent de les traiter. Koly a abordé certaines questions relatives à la dimension juridique de l'avortement au Sénégal. Ila également étudié la position de l'Islam et de l'Eglise sur l'avortement. . Enfin, Koly a formulé des recommandations en termes d'études et recherches sur l'avortement au Sénégal.
Source : Source : Ceped.Rapport
Corvalàn H.
La epidemia del aborto
1991 - Naciones unidas, CELADE, Santiago, Chile, 16
Source : Source : Ceped.Article de périodique
Megafu U.; Ozumba B.C.
Morbidity and Mortality from Induced Illegal Abortion at the University of Nigeria Teaching Hospital Enugu a Five Year Review
1991 - International Journal of Gynecology Obstetrics, 34(2), p. 163-168
Mots clés : complication; mortalité maternelle; incidence; âge; fécondité; état matrimonial; traitement; soin; hôpital; hospitalisation; avortement; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique; mesure; méthodologie; taux fécondité; maladie; complication; nuptialité; état matrimonial; mariage; service de santé; soin; santé
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : 84 cases of illegally induced abortion presented at the University of Nigeria Teaching Hospital (1982-86); this represents 4/1000 deliveries. 71% of the patients were 20 years or younger and 8 of 10 were nulliparous. Medical practitioners were responsible for 1/3 of the cases. Presentation and treatment are described. 15 women (179/1000) died but the true number of deaths from abortion in the community is in all probability higher. (author's modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 064825.Article de périodique
Makinwa Adebusoye P.K.
Pregnancy and abortion among urban youth in Nigeria
1991 - Etude de la Population Africaine = African Population Studies (SN), 6), p. p. 40-57
Pays / Régions : Nigeria
Source : Source Ceped : http://ceped.cirad.fr.Article de périodique
Okonofua F.E.; Ilumoka T.
Prevention of morbidity and mortality from induced and unsafe abortion in Nigeria. Proceedings of a seminar organised by the Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University, Ile-Ife (Nigeria), December 4-6, 1991
1991
Mots clés : loi; avortement; santé; service de santé; morbidité; mortalité; grossesse non prévue; grossesse non désirée; santé de la reproduction; femme; soin; facteur démographique; maladie; complication; planning familial; fécondité; contraception d'urgence; contraception postcoitale; population; soin de santé primaire; programme
Pays / Régions : Nigeria; Afrique; Afrique Subsaharienne; Afrique Anglophone; Afrique de l'OuestRésumé : This report is a synthesis of the presentations and the discussions of a multidisciplinary seminar that highlights the prevention of morbidity and mortality from induced and unsafe abortion in Nigeria. The seminar attempted to identify measures that could be undertaken on a short and long-term basis to reduce the rate of abortion-related mortality, and set an agenda for research into abortion in Nigeria.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 171555.Article de périodique
Konje J.C.; Obisesan K.A.
Septic abortion at University College Hospital, Ibadan, Nigeria
1991 - International Journal of Gynecology and Obstetrics, 36(2), p. 121-125
Mots clés : méthodologie; complication; mortalité maternelle; information; complication grossesse; maladie; complication; mortalité; population; facteur démographique
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : It is likely that up to one million induced abortions are performed annually in Nigeria. Restrictive laws against induced abortion in the country, however, force girls and women to obtain abortion services illegally from largely unqualified sources. In so doing, they suffer common and often severe complications which make abortion one of the major causes of morbidity and mortality in Nigeria. The level of abortion-related maternal mortality is increasing in Nigeria. This paper documents some of the problems of septic abortion, the types of organisms usually isolated, and offers suggestions on how to overcome the problems. Case records were reviewed on 119 cases of septic abortion treated at University College Hospital, Ibadan, Nigeria, from January 1981 to December 1985. Single girls aged 12-20 comprised 36.9% of the cases, while 42.9% of septic abortions were among secondary school students. Of the 82.3% of abortions which were induced, 57.1% occurred in private hospitals and clinics, 17.3% at chemist shops, 15.3% in various homes, and 5.1% in herbalists' homes. Gynecologists performed the abortions in only 2% of cases and 87.8% of the abortions were induced through instrumentation. 56.3% presented within seven days of abortion and 20.2% 8-14 days post abortion; only 2.5% presented for treatment after four weeks post abortion, although the interval was not stated in 4.2% of cases. Peritonitis was the most common complication of septic abortion, with either generalized or pelvic peritonitis occurring among 58.0% of patients. Death occurred in ten cases, of which four were the result of septicemic shock. The duration of hospital stay ranged 1-300 days, although the average stay was 24 days. Abortions occurring between the 10th and 13th weeks were associated with hospital stays of 57 days and longer. Identified from the cervix and vagina of 43.1% of cases, Escherichia coli was the most commonly isolated organism. Others were Klebsiella species (22.4%), Streptococcus fecalis (15.5%), Staphylococcus aureus (8.6%), Pseudomonas aeruginosa (8.6%), Proteus mirabilis (3.4%), and anaerobic hemolytic streptococci (1.7%). Legalizing abortion and providing abortion services in hospitals would go far to reduce the currently high levels of abortion-related morbidity and mortality.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 103725.Article de périodique
Ujah I.A.
Sexual activity and attitudes toward contraception among women seeking termination of pregnancy in Zaria, Northern Nigeria
1991 - International Journal of Gynecology and Obstetrics, 35(1), p. 73-77
Mots clés : sexualité; attitude; contraception; méthode contraceptive; avortement; ethnie; religion; culture; facteur socio-économique; psychologie; facteur psychologique; connaissance, attitude; pratique; CAP; collecte; fécondité; méthode; adolescence; adolescent; loi; comportement; planning familial; contraception d'urgence; contraception postcoitale; déterminant culturel; population; facteur démographique; facteur économique; méthodologie; taux fécondité; médicament; jeune; adolescent; âge
Pays / Régions : Nigeria; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : 108 women seeking pregnancy termination in Zaria were studied during a 3-month period, October-December 1985. The mean age was 21.8 years (range 15-38); 35.6% were below the age of 20 years and 57% were students. The 3 major tribes engage in illegal termination of pregnancy and Yorubas were in the majority; 53.3% had history of previous induced abortion. 63% had had sexual experience by the age of 18. The major reasons for seeking pregnancy termination were: being in school and being unmarried. Although 88.8% had knowledge of contraception, less than 1/2 actually used any method. Of the 60 patients who volunteered information on their views on legalization of abortion, 21 (35%) were against legalization of abortion for various reasons. Family health education in schools and contraceptive counseling among the adolescents will reduce the prevalence of illegal abortions and its disastrous consequences. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 066119.Article de périodique
Odujinrin O.M.
Sexual activity, contraceptive practice and abortion among adolescents in Lagos, Nigeria
1991 - International Journal of Gynecology and Obstetrics, 34(4), p. 361-366
Mots clés : sexualité; enquête; contraception; méthode contraceptive; avortement; adolescence; adolescent; étudiant; scolarisation; incidence; ville; résidence; âge; coït; sexualité; grossesse non prévue; grossesse non désirée; grossesse adolescente; grossesse; risque; maladie sexuellement transmissible; MST; IST; comportement; méthodologie; planning familial; contraception d'urgence; contraception postcoitale; jeune; adolescent; population; facteur démographique; éducation; mesure; santé de la reproduction; fécondité; IST; MST; infection; complication; maladie; complication
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : 950 randomly selected secondary schoolgirls were surveyed, the youngest of whom was age 12. 29% claimed that they were sexually active; however, age had no influence on the frequency of sexual intercourse. Multiple sexual partners, a high risk behavior for contracting sexually transmitted diseases, including AIDS, was demonstrated in 33.7% and only 20.3% used orthodox methods of contraception. Induced abortion was procured by 23.5% and most were procured from unskilled personnel and through unsafe methods. (author's modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 066255.Chapitre d'ouvrage
Lindsay J.
The politics of population control in Namibia
1991 - Women and health in Africa, p. p. 143-167. Trenton, New Jersey (US): Africa World Press Inc.
Mots clés : facteur politique; facteur économique; programme planning familial; hôpital; hospitalisation; politique; programme; grossesse adolescente; grossesse; loi; stérilité; collecte; méthodologie; ethnie; déterminant culturel; population; facteur démographique; contraception; méthode contraceptive; planning familial; facteur socio-économique; service de santé; soin; santé; santé de la reproduction; fécondité; avortement; contraception d'urgence; contraception postcoitale
Pays / Régions : Namibie; Afrique Australe; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Free family planning came to namibia via South African policy changes when South Africa controlled Namibia. Both countries maintained a policy of population control, which included family planning, migration control, and segregation by race. The aim was to reduce the black population. Women's personal experiences are related based on oral interviews that were conducted in 1983, 1985, and 1986. Official documentation in namibia is lacking. Women were interviewed from the black township of Katatura, Ovamboland, and Kavango; women were represented in the Herero, Nama, and Damara ethnic groups and of mixed origins (coloreds). The most accessible contraceptive is Depo-Provera injections. Katatura hospital personnel give injections immediately after childbirth regardless of family size or medical history and indiscriminately without the patient's consent; this practice was confirmed by women interviewed and denied by the hospital physician in charge. The common dosage is 450 ml, which is 3 times the normal dosage. One physician's report confirmed the arbitrary practice. Women are given injections even when physicians recommended an IUD or pills. The side effects of Depo-Provera complained about which discouraged continued use are amenorrhea or nonstop bleeding, decreased sexual interest, or diminished ability to conceive. There is speculation about the higher rates of cervical cancer in the north and its connection with Depo-Provera use. Criticism of this contraceptive is loosely considered a crime against the state. Depo-Provera campaigns are also directed specifically to teenagers because of high pregnancy rates among this population. Young girls are also given injections without parental permission. Unwanted pregnancies are dealt with through backstreet abortions and infanticide; parents also mistreat their pregnant teenager. Among the Ovambo in the north there is stigma against illegitimacy. Prostitution and poverty have placed women at risk. Other medical interventions that have been perpetrated without permission or with bullying tactics are the IUD and sterilization or hysterectomy, after a Cesarean birth or a standard dilatation and curettage. Suggestions are made for dealing with infertility, illegal abortion, management of Depo-Provera, method availability, and primary health care.
Source : Source POPLINE : http://db.jhuccp.org/popinform/basic.html - PIP 079613.
Ouvrage
McLaren A.
A history of contraception. From antiquity to the present day
1990 - Cambridge: Blackwell Oxford UK and Cambridge, 275 p.
Mots clés : enquête; contraception; méthode contraceptive; santé de la reproduction; sexualité; genre; planning familial; fécondité; population; facteur démographique; comportementRésumé : This is a study of the history of fertility regulation throughout the world and is based on two premises. "The first is that there have always been societies, or at least important groups within them, who have for one reason or another, at some periods in their history, taken steps to limit their progeny....The second premise...is that reproductive decisions are of greater significance to women than to men....In each of the book's seven chapters--devoted to the Greek world, the Roman Empire, the Christian west, the Middle Ages, early modern Europe, the industrializing west and the twentieth century--the intent has been to flush out the intended and unintended consequences of fertility control and the relationship to changing family forms and gender roles." (EXCERPT)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 091098.Article de périodique
Wycliffe B.
Abortion and the law in Uganda
1990
Mots clés : revue littérature; loi; éthique; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This thesis examines the existing abortion law in Uganda to reveal how it operates and its limitation as an anti-abortion social vehicle. The various and competing interests of an unwilling mother, a fetus, and society are considered, and other legal systems are reviewed for the purpose of comparison. As a result of this analysis, potential legal reforms are suggested for Ugandan abortion law. The first chapter of the paper presents its objectives, hypothesis, and research methodology as well as the results of a literature review and the theoretical framework. Chapter 2 looks at the law and its operation in terms of its history, what the law actually says, what constitutes an offense, what constitutes preparatory and inchoate offenses, cases where abortion is permitted, defenses, the punishment, and a critique of the law. This chapter notes that the law lacks clarity since it allows abortions to save a mother's life but does not attempt to define "health" or "life." The law is also found to be ineffective since the incidence of illegal abortion is increasing. Because the causes of abortion exist outside of the purview of the law, legal reform can not solve the problems attendant with abortion. The third chapter presents arguments for and against abortion from the point of view of the fetus, the mother, and society. The conclusion of this chapter notes that the real problem is how to prevent unwanted pregnancies. Chapter 4 discusses reforms and recommendations, including measures to control criminal abortion, education, sex education, family planning, moral rehabilitation, adoption, fostering, and the role of various women's organizations. In conclusion, the problem of abortion can not be solved legally, but the problems attendant with illegal abortion can be solved by liberalizing abortion laws.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 106668.Article de périodique
Knoppers B.M.; Brault I.; Sloss E.
Abortion law in francophone countries
1990 - American Journal of Comparative Law, 38(4), p. 889-922
Mots clés : enquête; loi; étudiant; scolarisation; méthodologie; avortement; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : France; Afrique Francophone; Europe de l'Ouest; Europe; Pays Méditerranéens; AfriqueRésumé : This is a review of abortion law in francophone countries around the world. "Undertaken in 1986-88, the objective of this study was to determine whether there was evidence of a similar type of juridical patrimony stemming back to early French legislation, and to see whether a similar trend toward liberalization is reflected in these countries. As a derivative of the substantial study undertaken, this paper attempts to highlight some of the most important issues revealed, briefly illustrate the influence of early French legislation, and to outline the state of the law at present." (EXCERPT)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 129991.Article de périodique
Chikamata D.M.
Abortion-related complications
1990
Mots clés : complication; mortalité maternelle; morbidité; femme; stérilité; législation; loi; contraception d'urgence; contraception postcoitale; planning familial; mortalité; population; facteur démographique; maladie; complication; famille; santé de la reproduction
Pays / Régions : Afrique Subsaharienne; AfriqueRésumé : This paper, presented at the 1990 Safe Motherhood Conference for SADCC countries in Harare, Zimbabwe, considers abortion-related issues in sub-Saharan Africa. The author discusses abortion and its consequences, including maternal mortality, morbidity, and infertility; access to abortion and legal issues; the quality of abortion-related services; and the need to improve the management of abortion complications. The author argues for improving the management of patients at all levels of the health system, including the community level, the primary level, the first referral level, and the second and tertiary levels; he also presents suggestions for improving management at each of these levels. The author concludes with a call to reform abortion laws within the SADCC countries.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101430.Article de périodique
Ogunniyi S.O.; Makinde O.O.; Dare F.O.
Abortion-related deaths in Ile-Ife, Nigeria: a 12-year review
1990 - African Journal of Medicine and Medical Sciences, 19(4), p. 271-274
Mots clés : mortalité maternelle; complication; hôpital; hospitalisation; fécondité; état matrimonial; âge; travail; infection; complication; éducation; mortalité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; information; service de santé; soin; santé; méthodologie; taux fécondité; nuptialité; état matrimonial; mariage; activité économique; facteur socio-économique; facteur économique; maladie; complication
Pays / Régions : Nigeria; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Deaths due to abortions at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between January 1977-September 1988 were reviewed. Abortion accounted for 12.5% of the maternal deaths and the majority (88.9%) were from illegal abortions. The majority (92.6%) of the patients had secondary school education and below, and both married and single women were included. Instrumentation was employed in 81.5% of the abortions and unqualified personnel were involved in 74.1% of the cases where intervention occurred. 17 (63%) of the pregnancies were terminated within the 1st trimester. Most (96.3%) of the patients were admitted in poor clinical state and 51.8% of them died within 48 hours of admission. Sepsis was the most common cause of death. (author's modified) (summaries in ENG, FRE)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 066914.Article de périodique
Kulin H.E.
Adolescent Pregnancy in Africa
1990 - World Health Forum, 11(3), p. 336-338
Pays / Régions : Afrique
Source : source : World Health Forum.Article de périodique
Kizza A.P.; Rogo K.O.
Assessment of the manual vacuum aspiration (MVA) equipment in the management of incomplete abortion
1990 - East African Medical Journal, 67(11), p. 812-822Résumé : In a study to assess the efficacy of and safety of vacuum aspiration syringe in the management of incomplete abortion, 300 patients with nonseptic abortion were evacuated by their method in the ward. A control group of 285 patients was evacuated in the theatre by sharp curettage. All patients were followed up for 21 days; 54.7% of the study patients were evacuated without any need for analgesia while all the control patients were given intravenous pethidine and valium. 2.3% of vacuum aspiration and 3.5% of control patients needed reevacuation (p.0.05). 70.3% of vacuum aspiration cases were dry by day 7 compared to 64.6% of the control group (p>0.05). Immediate complications of nausea and vomiting were seen in 5.3% of the study patients (p<0.001). There was 1 uterine perforation in the control group. 5.4% of the study and 6.0 of the control patients developed mild to severe sepsis (p>0.05). Vacuum aspiration is a safe, simple, and quick method of treating incomplete abortion. Its wider use in developing countries is highly recommended. (author's)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 066235.Article de périodique
Bleek W.
Did the Akan resort to abortion in pre-colonial Ghana? Some conjectures
1990 - Africa, 60(1), p. 121-131
Mots clés : histoire; demande; enquête; anthropologie; culture; contraception d'urgence; contraception postcoitale; planning familial; collecte; méthodologie; psychologie; facteur psychologique; comportement
Pays / Régions : Ghana; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The question of abortion practice in pre-colonial Ghana is the central topic of this work. The author performed exhaustive field work and data analysis to come to the conclusion. The study involves the interviews of women in a rural village as well as a control group consisting of men and women. Currently the women living in the region in question commonly have abortion in attempt to control their fertility, so it is assumed that the practice has gone on for a long time. However the author points out 3 reasons why this is not necessarily the case: the circumstances that now provoke women to have abortions did not manifest themselves in the pre-colonial era; the cultural and economics situation of pre-colonial women was such that abortion would be useless and absurd; and reliable field work failed to disclose any significant incidence of pre-colonial abortion. The author questioned the reliability of a male researcher interviewing male informants about the past practice of women. It is possible that pre-colonial women performed abortions without their husband's knowledge. The author feels that this is not likely because there are no indications of knowledge of this practice and the odds are not in favor of total ignorance. Simply put, if women were having abortions, eventually some men would have found out about it. Abortion in pre-colonial Ghana was probably rare and only performed in circumstances where pregnancy would lead to shame and hardship for woman. Adultery and pre-puberty rite pregnancies were the most common reasons for pre-colonial women to have abortions.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 063043.Article de périodique
Sene D.M.
Induced abortion in Bamako district. A phenomenon still difficult to graspL'avortement provoque dans le district de Bamako. Un phenomene encore difficile a saisir
1990 - Pop Sahel, 13), p. 17
Mots clés : méthodologie; enquête; déterminant; taux; hôpital; hospitalisation; grossesse adolescente; grossesse; loi; contraception d'urgence; contraception postcoitale; planning familial; service de santé; soin; santé; santé de la reproduction; fécondité; population; facteur démographique
Pays / Régions : Mali; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : During October-December 1988 in Mali, the Union for the Study of the African Population conducted an abortion survey among 335 women at nine maternity wards of hospital centers (Djikoroni, Gabriel Tore, Garnison, Hamdalaye, Korofina, Missira, Point G, Quartier Mali, and Sognoninko) throughout Bamako District to measure the extent of abortion in hospital centers in the district and to identify the principal causes for abortion. More than 90% of the women were Moslem. More than 50% were illiterate. 111 women (about 33%) had an induced abortion. They included students and women with no profession. 64% claimed that their poor state of health was responsible for the abortion. Fear of parents was the reason for undergoing an abortion among 10.7% of women while the reason was the pursuit of studies among 3.3%. 47 women were less than 18 years old. 23 of them said that poor health status was responsible for their abortion. Other reasons among adolescents were fear of parents (10), pursuit of studies (5), difficult financial situation (3), not knowing the man responsible for their pregnancy (3), and other causes (3). Among the 111 women who had undergone induced abortion, poor state of health was the reason for the abortion in 22% of the students and among their lack-of-profession counterparts. Fear of parents, pursuit of studies, and difficult financial situation were reasons for abortion among 55.6% of women without a profession compared to 66.6% among students. It is difficult to get an exact count of the extent of induced abortion in Bamako District since this survey only covered hospitals. It is known that many abortions are performed clandestinely. It would be interesting to conduct a more expanded survey which would cover abortions practiced outside of official health facilities. This would allow a comparative analysis between adolescent pregnancy and induced abortions and elucidation of their causes.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 107002.Article de périodique
Diadhiou F.; Koly F.
Induced abortion in Senegal. What justification?Avortement provoque au Senegal. Quelles justifications?
1990 - Pop Sahel, 13), p. 18-21
Mots clés : loi; grossesse adolescente; grossesse; infection; complication; complication grossesse; avortement thérapeutique; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; population; facteur démographique; maladie; complication
Pays / Régions : Sénégal; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique FrancophoneRésumé : Physicians consider an adolescent pregnancy to be a high risk pregnancy. An immature adolescent body often explains early loss of first pregnancy. Pregnancy tends to have a disastrous effect on the development and harmonious growth of the adolescent body, especially when it occurs shortly after the beginning of puberty. Adolescents tend not to receive prenatal care, to have a difficult labor and delivery, and to undergo obstetrical surgery. All these troubles explain, if not justify, recourse to illegal abortion with its effects (mortality, morbidity, and sterility). In Senegal, there is still much to do to make adolescent pregnancy justification for legal abortion. Practicing an abortion on an adolescent has two indications: therapeutic abortion and criminal abortion. In Senegal, physicians must discuss the indications for therapeutic abortion with specialists and the couple requesting the abortion, then submit a report to the Order of Physicians. Criminal abortion is disapproved on a legal, religious, and social basis. In rural areas, the family (especially an aunt or the grand-mother) affectionately embraces a pregnant adolescent and prepares her for her role as a future mother. Based on honor, the pregnant girl's mother tends to reject the pregnancy. In urban areas, a pregnant adolescent is advised to obtain social assistance. Social assistance refers her to a health center and provides her moral and sometimes material support. If the pregnancy is not wanted based on health reasons, the physician will complete her record with a therapeutic abortion in mind. The probability of a urinary infection during pregnancy and during the puerperium is proportional to the age of the patient and is highest during the second trimester and among women in the lowest socioeconomic group. All women with blood in their urine have a urinary infection. In Senegal, it is legally easier to obtain an abortion during the first trimester than the other trimesters.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 107001.Article de périodique
Khasiani S.A.
Kenyatta National Hospital indepth individual interviews of MVA use in management of incomplete abortions
1990
Mots clés : méthodologie; enquête; avortement; aspiration; méthode; curetage; méthode; traitement; soin; Anesthésie; hôpital; hospitalisation; personnel de santé; collecte; évaluation; contraception d'urgence; contraception postcoitale; planning familial; intervention chirurgicale; méthode; intervention chirurgicale; service de santé; soin; santé
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In the late 1980s, Kenyatta National Hospital (KNH) affiliated with the University of Nairobi acquired manual vacuum aspiration (MVA) capabilities to perform abortions. MVA was introduced here to reduce the number of and maternal deaths due to incomplete abortions in Kenya. Before KNH started doing MVAs, most incomplete abortion cases were admitted to the hospital. Moreover infection was high frequently leading to death. Indeed there were so many cases that admissions, the ward area, and the main hospital were crowded and hospital personnel were under much pressure. Therefore the quality of services suffered at KNH. After acquiring MVA capabilities, crowding eased significantly and the abortion occurred much more quickly than it did using dilation and curettage (DC). Hospital personnel interviewed in 1990 agreed that MVA should replace DC and other institutions. Further, they suggested that incomplete abortion cases should be treated as outpatients. Most respondents, particularly the nurses, said that the practical training for MVA was not satisfactory. In addition, they believed that newly trained, insecure physicians were not properly being supervised. The physician and consultant respondents believed the MVA technique easy enough to learn that medical students, senior nurses, and paramedical staff could do it thereby allowing physicians more time to perform other duties. Not all the nurses agreed however. They felt that only senior physicians should perform the MVA technique just in case complications would arise that nonphysicians could not treat and since it is an operation.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 067908.Article de périodique
Kamau R.K.
Management of incomplete abortion: the role of manual vacuum aspiration
1990
Mots clés : évaluation; service de santé; aspiration; méthode; complication; traitement; soin; personnel de santé; soin; santé; contraception d'urgence; contraception postcoitale; planning familial
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : The purpose of this paper is to present the experience of the personnel at Kenya's Kenyatta National Hospital (KNH) with the introduction and use of manual vacuum aspiration (MVA) for treatment of incomplete abortion at gestations of 16 weeks or less. (Although the International Projects Assistance Services package insert clearly states that MVA be used for uterine evacuation for uterine sizes of 12 weeks or less since the last menstrual period.) Before the introduction of MVA at KNH in 1987, incomplete abortion cases constituted 70% of all gynecological emergency admissions, and bed occupancy in the 26-bed ward was 270%. Between November 1988 and April 1989, 2436 MVA procedures were performed, for an average of 394 MVA cases per month. Health workers were requested to answer a structured questionnaire about their experiences and observations on the ward before and after the introduction of MVA; the responses of 18 nurses are reported. Prior to the introduction of MVA, congestion on the ward was the biggest problem (reported by 100% of the respondents), followed by the length of pre-evacuation hospital stays, which were often over 24 hours, (answered by 50%). The benefits of MVA included reduced length of hospital stay (reported by 83.3%), less congestion (66.7%), better patient care (38.9%), and a lighter workload for the nurses (38.9%). MVA was found to be easy to use and more effective than dilation and curettage (DC) on the seventh post-treatment day, 97.7% of the MVA cases and 96.5% of the DC cases were found to be successful evacuations, and all of the failed MVA evacuations occurred during the first month of the study, while the failed DC evacuations occurred throughout the 3-month study period. The authors recommend that Kenyan hospitals adopt the MVA procedure for treatment of incomplete abortion.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 101346.Article de périodique
Unuigbe J.A.; Orhue A.A.; Oronsaye A.U.
Maternal mortality at the University of Benin Teaching Hospital Benin
1990 - Tropical Journal of Obstetrics and Gynaecology, 1(1), p. 13-18
Mots clés : mortalité maternelle; méthodologie; programme; service de santé; demande; décès; hôpital; hospitalisation; âge; avortement; grossesse adolescente; grossesse; enquête; mortalité; population; facteur démographique; soin de santé primaire; soin; santé; facteur économique; évaluation; contraception d'urgence; contraception postcoitale; planning familial; santé de la reproduction; fécondité; étudiant; scolarisation
Pays / Régions : Bénin; Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique Francophone; Afrique AnglophoneRésumé : A study of 165 maternal deaths at the University of Benin Teaching Hospital, Benin City over a 13-year period (from April 1, 1973 to December 31, 1985) is presented. All patients' case files were recovered from the central records library and each case file was carefully analyzed. With a total delivery of 29,324, the maternal mortality rate, inclusive of death from abortion, was 563/100,000 deliveries. There was a general increase in maternal mortality rate with age and this became alarming from 35 years. There was an equally high mortality rate among teenagers, mainly accounted for by illegally induced abortion. Indeed, abortion accounted for 72% of teenage mortality. A statistically significant association between maternal deaths and parity (p, 0.001) was observed. The most important causes of death were hemorrhage with a total of 26 out of 42 deaths, sepsis, and abortion. Other important causes were hypertensive disorders such as eclampsia, liver and respiratory disease, anemia, trophoblastic diseases, caesarean sections, and acute renal failure. Additional causes of maternal deaths include tetanus, sickle-cell disease, anesthetic death, drug reactions, pulmonary embolism, acute pyogenic meningitis, typhoid disease, urinary bladder tumor, acute lymphoblastic leukemia, and carcinoma of the breast thyroid. Factors identified with these deaths included such health services factors as deficient medical treatment of obstetric complications, lack of adequate personnel at primary and secondary health care levels, lack of access to maternal health services, and consequently, lack of prenatal care. Extreme reproductive age, grandmultiparity, and unwanted pregnancies, especially among teenagers, also contributed to maternal deaths. Overhaul of the maternal health care services at national level to include organization of such programs as provision of adequate blood transfusion facilities, prompt treatment of infections, early referrals of patients at risk to secondary and tertiary health centers, intensified family planning programs, and liberalization of abortion laws are recommended in order to reduce the unacceptably high maternal mortality. (authors' modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - CPFH 27201cr988.Article de périodique
Castle M.A.; Likwa R.N.; Whittaker M.
Observations on abortion in Zambia
1990 - Studies in Family Planning, 21(4), p. 231-235
Mots clés : loi; complication; mortalité maternelle; enquête; service de santé; hôpital; hospitalisation; traitement; soin; attitude; médecin; personnel de santé; méthodologie; contraception d'urgence; contraception postcoitale; planning familial; complication grossesse; maladie; complication; mortalité; population; facteur démographique; étudiant; scolarisation; évaluation; soin de santé primaire; soin; santé; psychologie; facteur psychologique; comportement; personnel de santé
Pays / Régions : Zambie; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : This report describes qualitative observations of the 1 day at the Gynecological Emergency Ward, University Teaching Hospital, Lusaka, for September, 1988; and 2 case histories of abortion patients. These women had complications of illegally induced incomplete abortions. They came to the (UTH) for medical treatment. Each day 3 out of 10 illegally induced abortion patients complete the abortions on a concrete floor with no medical care. No medication or analgesics can be given without a prescription by a physician. If it is determined that a woman has had a proper, complete abortion, she is observed for at least 8 hours and released. Only 1 physician is available to many women. Due to blood shortages, few women who need blood get it. Women who have abortion- related infections need antibiotics which they may or may not get. Hysterectomy, ectopic pregnancy, and sterility are complications of improperly performed abortions. The consent of 3 physicians is required for an abortion--1 must be a specialist in a branch of medicine related to the woman's reason for wanting an abortion. Physicians are reluctant to schedule appointments despite the legalization of abortion in 1972. Junior physicians perform the abortions in the operating room. Some private physicians insert an IUD to induce abortion and tell the women to go to the gynecology ward at the hospital when bleeding begins. Other private doctors insert a plastic cannula and tell the women to go to the hospital ward. Most women go to traditional healers or midwives who insert roots soaked in water into the cervix which act as an irritant/dilator. Traditional healers also provide herbs claimed to be abortifacients which are taken in tea or eaten. At least 114 of the women at UTH induce abortion themselves by inserting plants or twigs into the cervix. Desperate and often the youngest women drink gasoline or detergents or take large overdoses of chloroquine, aspirin, or other toxic substances. All the women are afraid of dying from abortions. Poorly performed abortion is a major cause if maternal mortality in the 3rd world. Abortion-related death rates have been guessed to be 50- 100/100,000 illegal procedures compared to 1/100,000 legal abortions in the US. A study should be planned at UTH to determine how health care delivery can be improved for abortion seekers. (author's modified)
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 062622.Article de périodique
Okagbue I.
Pregnancy termination and the law in Nigeria
1990 - Studies in Family Planning, 21(4), p. 197-208
Mots clés : loi; politique; programme; loi; justice; épidémiologie; prévalence; méthodologie; demande; avortement; contraception d'urgence; contraception postcoitale; planning familial; mesure; facteur économique
Pays / Régions : Nigeria; Afrique de l'Ouest; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : In Nigeria, abortion is illegal and carries a stiff jail sentence, up to 14 years, unless done to save the life of the pregnant woman. Abortion legislation in Nigeria and court decisions on the subject are examined. Abortion is governed by the Criminal Code in the southern states, and the Penal Code in the northern states. In "R v. Idiong and Umo," the 2 defendants had been convicted of murder on the grounds that the 1st accused had obtained the services of the 2nd accused, a native doctor, to give native medicine to bring about an abortion. The abortion resulted in the woman's death. Therefore the 1st accused was party to the crime. The West African Court of Appeal found that the 2nd accused had acted innocently believing that the medicine would relieve pain that the dead woman suffered from a retained placenta. He gave an abortifacient for expulsion of the placenta. He was found "not guilty" of murder and manslaughter. The 1st accused was found criminally responsible for causing the abortion, but was found not guilty of murder. He was guilty of manslaughter, however. In 1981, the Nigerian Society for Gynecology and Obstetrics sponsored a Termination of Pregnancy Bill in the House of Representatives. However, pressure groups lobbied against it, and the bill did not pass. In 1984, a survey was done to assess incidence of abortion. Representative samples were taken from the north and the south. The capital cities of 8 different states were covered. In 5 sample hospitals within the Lagos Metropolis in Lagos State, 125 abortions or treatments of incomplete abortions were recorded within a month. In 4 representative hospitals from Oyo State, 81 abortions or corrections of incomplete abortions were recorded within 1 month. In the northern state of Kaduna, information was very difficult to obtain. At one of the University Teaching Hospitals in Zaria, records showed there were 103 treatments of incomplete abortions during the preceding year. The usual approach to revising abortion laws has been to expand or extend the grounds for legal abortion. In some jurisdictions, courts have widened the ground by adopting the decision that life includes mental and physical health. Abortion may be possible for eugenic reasons. In February, 1988, the Nigerian government announced its adoption of a population policy; a new abortion policy should take this into consideration.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 062625.Article de périodique
Bradley J.
The cost of treating incomplete abortion in Kenya: a cost comparison of two treatment regimes
1990
Mots clés : méthodologie; enquête; coût; curetage; méthode; aspiration; méthode; traitement; soin; Anesthésie; hôpital; hospitalisation; mortalité maternelle; étudiant; scolarisation; évaluation; contraception d'urgence; contraception postcoitale; planning familial; intervention chirurgicale; méthode; intervention chirurgicale; service de santé; soin; santé; mortalité; population; facteur démographique
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : About 30,000 women died each year in public hospitals in Kenya in the 1980s as a result of an incomplete abortion. Most of these women underwent sharp curettage to empty the uterus. Between 1988-1989, 15 district or provincial hospitals and the Kenyatta National Hospital (KNH) acquired a manual vacuum aspiration (MVA) pump which allowed staff to perform the abortions upon request and usually without anesthesia. In March-June 1991, a researcher studied data and observed patients from KNH and Kisii district hospital, both of which used MVA and district hospitals in Eldoret and Machakos which 1st used sharp curettage then switched to MVA to compare costs between the 2 procedures. Sharp curettage averaged a 25.5 hour waiting time and a 1.7 day stay at Eldoret where abortions were done daily and 90.2 hours and 4.2 days respectively at Machakos where they were done 2 times a week. Average waiting time and total stay for all MVAs stood at 11.6 hours and 1 day respectively. The reduction in total average stay in Eldoret was 41% and 76% in Machakos. Even though total contact time and cost for physicians did not vary much, time and costs for nurses and other contact staff were higher for curettage than for MVA. For example, staff costs at Machakos were 43% higher for sharp curettage than MVA. Moreover MVA significantly reduced inpatient costs from Kshs 47.9-Kshs 25.3 in Eldoret and from Kshs 422.5-Kshs 144.8 in Machakos. Since MVA did not generally require anesthesia and patients did not need a transfusion, intravenous fluids, and antibiotic therapy, the only equipment costs was the MVA pump. So MVA reduced equipment costs 38%, except in Eldoret, but these higher costs were offset by reduced staff and inpatients costs. In conclusion, MVA in all public hospitals in Kenya could save the Ministry of Health money and staff time.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 067907.Article de périodique
Khasiani S.A.; Baker J.
The link between abortion and contraceptive use in Kenya
1990
Mots clés : méthodologie; enquête; avortement; loi; contraception; méthode contraceptive; échec de contraception; éducation; pauvreté; fécondité; état matrimonial; connaissance, attitude; pratique; CAP; attitude; connaissance; étudiant; scolarisation; collecte; contraception d'urgence; contraception postcoitale; planning familial; facteur socio-économique; facteur économique; taux fécondité; population; facteur démographique; nuptialité; état matrimonial; mariage; psychologie; facteur psychologique; comportement; communication
Pays / Régions : Kenya; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Interviewers informally spoke with 35-40 women at health facilities and within the communities in Nairobi, Kenya who underwent at least 1 abortion to learn the relationship between abortion and contraceptive use by examining personal, family level, and community level factors. 43% had >1 abortion and had their 2nd abortion within 6 months of the 1st abortion and had subsequent abortions. Only 33% of these women were currently using a contraceptive compared to 50% of those who had had only 1 abortion. Indeed the unwanted pregnancies occurred because of contraceptive failure, contraceptive mismanagement, or mishaps from method switching. Further many respondents had used contraception before the unwanted pregnancy, but those that stopped did so because they feared the side effects. Most of all the respondents were poor, young, and single and had 1 child. They also had some primary or secondary schooling. Significant personal factors between abortion and contraceptive use included education, income, number of living children, marital status, knowledge of contraception, attitude towards contraception, and past contraceptive experience. Attitude of family members toward contraceptive use and their contraceptive experience comprised family level factors. Source of contraceptive knowledge, sources of contraceptive services, and awareness of population pressures were the significant community level factors. Therefore family planning programs should target poor, young, and single women with at least 1 child. Specifically, they should emphasize information, education, and communication strategies and improve access to quality family planning services. More research on the link between contraception use and abortion is needed.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 067898.Article de périodique
Paul B.M.
Unwanted pregnancies among school girls and the law in Uganda
1990
Mots clés : grossesse non prévue; grossesse non désirée; grossesse adolescente; grossesse; avortement; adolescence; adolescent; loi; programme planning familial; santé de la reproduction; fécondité; population; facteur démographique; contraception d'urgence; contraception postcoitale; planning familial; jeune; adolescent; âge; politique; programme
Pays / Régions : Ouganda; Afrique de l'Est; Afrique Subsaharienne; Afrique; Afrique AnglophoneRésumé : Adolescents worldwide are sexually active. Many do not use contraception when having sexual intercourse. In so doing, many adolescent females become pregnant and choose to abort their fetuses. These induced abortions take place in all societies regardless of whether the practice is legal or not. Abortion in Uganda is a criminal offense, permitted only to save the life of the pregnant woman, to protect her mental health, and in cases of rape, incest, and other acts of socially unacceptable sexual intercourse resulting in pregnancy. Despite this restrictive legislation, many women in Uganda undergo abortion, especially adolescents. The author stresses that young people will continue to explore their sexuality as a natural part of their human development. Without information on sex and sexuality, as well as contraceptive methods, sexually active young women will continue to have unwanted pregnancies and subsequent abortions. It is government policy in Uganda to provide family life education and contraceptives which must reach under-aged youths and be openly advertised. Section 38(1) of the penal code could, however, be interpreted as prohibiting the publication of sex education literature. The author hopes that regulations against obscenity will not impede the delivery of necessary information to school girls.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 106706.