Hormonal contraceptive prescriptions in Colombia and Zika virus

Machado‐Alba, Jorge Enrique; Machado‐Duque, Manuel Enrique; Gaviria‐Mendoza, Andrés; Orozco-Giraldo, Viviana A

doi:10.1016/s0140-6736(16)30429-9

Cited by 10 publications

(15 citation statements)

References 3 publications

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“…The first health system building block ('BB'), leadership and governance (Table 2(a)), is particularly important for policies regarding ZIKV prevention in pregnancy and childbirth. Many ZIKV-affected countries in LAC are advising women not to become pregnant for between 6 and 12 months, until the epidemic phase of the disease ends [25]. Policies in this area ethically entail offering complete, accurate and timely information and respecting women's right to choose '[c]omprehensive sexual and reproductive care [encompassing] family planning, maternal health, pre-natal testing, safe termination of pregnancy, counseling, and post-natal care services' [20, p.7].…”

Section: Preventionmentioning

confidence: 99%

“…Partly as a result, many cultural or religious norms prohibit or discourage open discussion of sexual issues among couples and even with health educators [28]. The HIV/AIDS pandemic has helped break down such barriers in the interests of public health [25] by, for example, involving religious leaders, peers, and educators, a lesson that could be applied to ZIKV as well.…”

Section: Preventionmentioning

confidence: 99%

“…Full information and informed consent must be assured for women asked to participate in clinical trials related to pregnancy or for post-mortem fetal examinations for research purposes. Men should also be involved in studies of natural history, infectivity, and clinical trials of vaccines and antiviral drugs [25].…”

Section: Preventionmentioning

confidence: 99%

“…However, even where contraception is encouraged by governments to avoid pregnancy in ZIKV endemic areas, uptake may be hindered by gender constraints. In Colombia, for example, a study of contraceptive use before and after a government-issued advisory encouraging women to delay childbearing due to possible ZIKVrelated birth defects and permitting access to abortion in the case of infection found no increase in uptake of either option following the advisory [25]. The authors attributed this to cultural barriers and gender inequality, including women's lack of autonomy in sexual and reproductive matters, inadequate sex education, and limited contraceptive access.…”

Section: Introductionmentioning

confidence: 99%

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A human rights-based framework to assess gender equality in health systems: the example of Zika virus in the Americas

Vlassoff

John

2018

Global Health Action

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Background: The right to health was enshrined in the constitution of the World Health Organization (WHO) in 1946 and in the Universal Declaration of Human Rights in 1948. The latter Declaration, which also guaranteed women's rights, was signed by almost all countries in the world. Subsequent international conventions reinforced these rights, requiring that women be able to realize their fundamental freedoms and dignity. Although the value of incorporating gender into health systems has been increasingly acknowledged over the years, gender inequalities in health persist. Objective: To introduce a tool to help countries assess their performance in addressing gender inequalities in their health systems, using the example of the Zika virus (ZIKV) in countries of the Americas. Methods: This paper is based on comprehensive reviews of the literature on the links between gender equality, health systems and human rights, and available scientific evidence about an adequate response to ZIKV. Results: The authors present a simple two-part framework from the human rights perspectives of the health system as duty bearer, incorporating WHO's six health system building blocks, and of its clients as rights holders. The authors apply the framework to ZIKV in the Americas, and identify strengths and weaknesses at every level of the health system. They find that when considering gender, health systems have focused mainly on dichotomous sex differences, failing to consider broader gender relations and processes affecting access to services, quality of care, and health outcomes. Conclusions: The authors' framework will permit countries to assess progress toward gender equality in health, within the context of their human rights commitments, by examining each health system building block, and the degree to which clients are realizing their rights. By applying the framework to specific health conditions, gender-related achievements and shortcomings can be identified in each health system component, fostering a more comprehensive and gender-sensitive response.

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Section: Preventionmentioning

confidence: 99%

Section: Preventionmentioning

confidence: 99%

Section: Preventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A human rights-based framework to assess gender equality in health systems: the example of Zika virus in the Americas

Vlassoff

John

2018

Global Health Action

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“…Nonetheless, they express some dismay that "no evidence exists of adherence to the proposal to reduce the risk of malformations in the country with the second highest number of reported cases of ZKV infection in the Americas," and note that lack of equitable access to quality reproductive health services is a significant concern. 31 In Brazil, a recent study explored current pharmacist knowledge and practices regarding oral EC. Reassuringly, emergency contraceptive pills were widely available from many pharmacies "at consistent prices in three very different regions" of the country.…”

Section: Contraceptive Prevalence In Latin American Countries Affectementioning

confidence: 99%

Family Planning and Zika Virus: The Power of Prevention

Burke

Moreau

2016

Semin Reprod Med

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The connection between infection with the Zika virus (ZKV) and congenital anomalies such as microcephaly has been generally accepted. Although efforts are underway to develop preventive interventions such as vaccines, these are not yet available. Family planning is an effective preventive approach that has been underemphasized in many lists of research priorities. In addition to acquisition of ZKV from mosquitoes, sexual transmission from males to females has been documented. Women at risk of ZKV need access to effective contraception if they want to avoid or postpone pregnancy, as well as access to safe abortion. There is often overlap between areas where risk of ZKV acquisition is highest, and areas where access to reproductive health services may be more limited. Data on the impact of ZKV on contraceptive use and abortion are sparse, but a few studies have begun to address these questions. ZKV highlights the need to provide at-risk women and couples with effective means to prevent or postpone childbearing. Contraception, prenatal care, and safe abortion should be available to all women.

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