Family planning and the post-2015 development agenda

Petruney, Tricia; Wilson, Lucy C; Stanback, John; Cates, Willard

doi:10.2471/blt.14.142893

Cited by 19 publications

(24 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Contraceptives allow women/couples to decide if and when to become pregnant. Modern contraceptives play an important role in reducing maternal deaths by preventing unwanted pregnancies and prolonging birth intervals [ 9 ]. Contraceptives are, however, underutilised in many low-resource settings [ 10 , 11 ], largely as a result of limited availability of a range of contraceptive methods, including to modern long-acting reversible contraceptive methods [ 11 ], and social stigma surrounding young women’s contraceptive use [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya

et al. 2018

View full text Add to dashboard Cite

BackgroundUnwanted pregnancies and unsafe abortions are prevalent in regions where women and adolescent girls have unmet contraceptive needs. Globally, about 25 million unsafe abortions take place every year. In countries with restrictive abortion laws, safe abortion care is not always accessible. In Kenya, the high unwanted pregnancy rate resulting in unsafe abortions is a serious public health issue. Gaps exist in knowledge regarding women’s decision-making processes in relation to induced abortions in Kenya. Decision-making is a fundamental factor for consideration when planning and implementing contraceptive services. This study explored decision-making processes preceding induced abortion among women with unwanted pregnancy in Kisumu, Kenya.MethodsIndividual face-to-face in-depth interviews were conducted with nine women aged 19–32 years old. Women who had experienced induced abortion were recruited after receiving post-abortion care at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) or Kisumu East District Hospital (KDH) in Kisumu, Kenya. In total, 15 in-depth interviews using open-ended questions were conducted. All interviews were tape-recorded, transcribed and coded manually using inductive content analysis.ResultsRespondents described their own experiences regarding decision-making preceding induced abortion. This study shows that the main reasons for induced abortion were socio-economic stress and a lack of support from the male partner. In addition, deviance from family expectations and gender-based norms highly influenced the decision to have an abortion among the interviewed women. The principal decision maker was often the male partner who pressed for the termination of the pregnancy indirectly by declining his financial or social responsibilities or directly by demanding termination. In some cases, the male partner controlled decision-making by arranging an unsafe abortion without the woman’s consent. Strategic choices regarding whom to confide in were employed as protection against abortion stigma. This contributed to a culture of silence around abortion and unwanted pregnancy, a factor that made women more vulnerable to complications.ConclusionsThe findings suggest that financial, social and gender-based dependencies influence women’s agency and perceived options in decision-making regarding abortion.

show abstract

Section: Introductionmentioning

confidence: 99%

Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The Sustainable Development Goals (SDGs) 3 (ensure good health and well-being) and 5 (achieve gender equality and empower all women and girls) encompass universal sexual and reproductive health. Family planning can also help to achieve other SDGs [3,14,15] by enabling women to stay employed or to complete education, reducing poverty and gender inequalities [3,16,17]. Through increases on human capital and social interaction, education may lead women to change their expectations about the future and to improve their autonomy and access to sexual and reproductive health services, playing an important role to reduce social and cultural barriers and increase modern contraceptive use [18-20].…”

mentioning

confidence: 99%

Time trends in demand for family planning satisfied: analysis of 73 countries using national health surveys over a 24-year period

Hellwig

Coll

Ewerling

et al. 2019

Journal of Global Health

View full text Add to dashboard Cite

BackgroundUniversal access to family planning is key to extend its health and economic benefits worldwide. Our aim was to track progress in demand for family planning satisfied with modern methods (mDFPS) and its inequalities in low- and middle-income countries (LMICs).MethodsAnalyses were based on Demographic and Health Surveys and Multiple Indicator Cluster Surveys carried out between 1993 and 2017 in 73 LMICs, using data for married women aged 15-49 years. We estimated trends in mDFPS coverage by country and world region and evaluated trends in wealth-based inequalities. The analyses pooling all countries together were stratified by wealth quintiles, area of residence and woman’s age. mDFPS coverage in 2030 for each country was predicted using a linear model.ResultsOverall, mDFPS increased and poor-rich gaps narrowed. Eastern & Southern Africa showed an average increase of 1.5 percentage points (p.p.) a year, being the region with the fastest progress. West & Central Africa had an increase in mDFPS of 1 p.p. a year but current coverage is still below 40%. Generally, inequalities were reduced, except for West & Central Africa and Europe & Central Asia where almost no change was observed. The country with the fastest progress in mDFPS was Rwanda, with an increase of 5 p.p./y, while Timor Leste had the fastest reduction in absolute inequality, less 3.8 p.p./y. Inequalities by area of residence were reduced, but large gaps remain. A similar trend was observed for different age groups. If the current trend is not accelerated, 44 countries will not achieve universal coverage in mDFPS by 2030.ConclusionsGenerally, mDFPS is increasing and inequalities are decreasing. However, progress is slow in some regions, especially West & Central Africa, where low coverage is combined with high levels of inequalities. Efforts to increase family planning coverage must be prioritized in countries where progress is slow or inexistent.

show abstract

“…of twenty people are cancelled out by the birth of one extra child [ 83 ]. It follows that in the US the dedicated lifetime climate-conserving efforts of 14 million people are neutralised as the result of the above-mentioned 720,000 unintended, not merely mistimed, births resulting from contraceptive failure and non-use every year, [ 57 , 84 – 87 ]. A study commissioned by the UK-based charity Population Matters together with Lancaster University asserts: “Reducing future energy demand by preventing unwanted births and hence lifetimes in developed as well as developing countries is far cheaper — US $1.11 per ton reduction in CO2 emissions — than any renewable energy alternative.…”

Section: Without Family Planning One Needs Migration Planningmentioning

confidence: 99%

Recent developments have made female permanent contraception an increasingly attractive option, and pregnant women in particular ought to be counselled about it

Verkuyl

2016

Contracept Reprod Med

View full text Add to dashboard Cite

BackgroundDespite the increased prevalence of reversible contraception, global unintended pregnancy rates are stable. Mistakes, method failures, side effects, alcohol, stock-outs, fears, costs, delays, myths, religious interference, doctors with other priorities, traditions and lack of health professionals may all factor in. Yet these unintended pregnancies ― nearly a hundred million annually ― cause much individual suffering, and in the long run, can aggravate conflicts, poverty, forced emigration and climate change. Presently, non-poor women postpone childbearing because of longer educational trajectories and careers. Sterilisations are therefore less often regretted or coerced. For poor-resourced women with a completed family, an unwanted pregnancy often has serious consequences, including crossing the (extreme) poverty line in the wrong direction, choosing an unsafe abortion, or even death. Caesarean sections (CSs), which currently stand at around 23 million annually, are increasing. On an “intention-never-to-become-pregnant-again” analysis, choosing a partial, and even more so a total bilateral tubectomy to be implemented during an ― anyway performed ― CS is by far the most reliable and safe contraceptive choice compared to meaning to start female or male sterilisation or any other contraceptive method later, and it reduces the chance of a future ovarian carcinoma substantially. CSs make subsequent pregnancies more dangerous. Simultaneously, they provide convenient, potentially cost-free opportunities for voluntary permanent contraception (PC): particularly important if there is no guaranteed future access to reliable contraception, safe abortion and well-supervised labour.Partial solutionMillions of women are within reach of attaining freedom from the “tyranny of excessive fertility” when they have a CS. Therefore, any woman who might conceivably be of the firm opinion that her family will be (over) completed after delivery should antenatally have “what if you have a CS” counselling to assess whether she would like a tubectomy/ligation. Yet many are not provided with this option: leading to frequent regret, more often than having been giving that choice would.ConclusionWithholding antenatal counselling about the option of PC for in case the delivery might become a CS is very prevalent, yet often more medically risky, and morally questionable than when, even in labour, a doctor sometimes decides in the absence of earlier counselling, considering numerous factors, to provide the choice to undergo a concurrent sterilisation if s/he is convinced that would be in the patient’s best interest.

show abstract

Family planning and the post-2015 development agenda

Cited by 19 publications

References 5 publications

Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya

Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya

Time trends in demand for family planning satisfied: analysis of 73 countries using national health surveys over a 24-year period

Recent developments have made female permanent contraception an increasingly attractive option, and pregnant women in particular ought to be counselled about it

Contact Info

Product

Resources

About