Situating the Mexico City Policy: what shapes contraceptive access and abortion?

Zulu, Joseph Mumba; Haaland, Marte Emilie Sandvik

doi:10.1016/s2214-109x(19)30278-5

Cited by 11 publications

(9 citation statements)

References 10 publications

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“…The authors argue that this increase in clandestine abortions is a consequence of a decreasing use of contraceptives, as the organisations affected by the policy are also important distributors of modern contraceptives. In a commentary in The Lancet, two of the authors of the present collection commend Brooks and colleagues for adding much needed documentation of the wide-ranging effects of the Mexico City Policy [6]. However, the authors also remind us of the need to situate global mechanisms -like the Mexico Policy -within the specific contexts where they take effect.…”

Section: Introductionmentioning

confidence: 96%

Reproductive health and the politics of abortion

Blystad

Haukanes

Tadele

et al. 2020

Int J Equity Health

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This editorial provides an overview of a thematic series that brings attention to the persistently deficient and unequal access to sexual and reproductive health services for young women in sub-Saharan Africa. It represents an effort to analyze the multifaceted relationship between laws, policies and access to services in Ethiopia, Zambia and Tanzania. Using a comparative perspective and qualitative research methodology, the papers presented in this issue explore legal, political and social factors and circumstances that condition access to sexual and reproductive health services within and across the three countries. Through these examples we show the often inconsistent and even paradoxical relationship between the formal law and practices on the ground. Particular emphasis is placed on safe abortion services as an intensely politicized issue in global sexual and reproductive health. In addition to the presentation of the individual papers, this editorial comments on the global politics of abortion which represents a critical context for the regional and local developments in sexual and reproductive health policy and care provision in general, and for the contentious issue of abortion in particular.

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Section: Introductionmentioning

confidence: 96%

Reproductive health and the politics of abortion

Blystad

Haukanes

Tadele

et al. 2020

Int J Equity Health

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“…Family planning and contraceptive (FP/C) programmes recommend community participation as a key strategy for improved service provision [5]. This is partly because uptake of FP/C methods and services is shaped by several socially embedded community factors such as religious values, political climate and dominating moral understandings [6]. Key policies such as the Family Planning 2020 (FP 2020), note that community participation is vital in expanding access to information, services and supplies to women and girls in remote communities [7].…”

Section: Introductionmentioning

confidence: 99%

Facilitating community participation in family planning and contraceptive services provision and uptake: community and health provider perspectives

et al. 2020

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Background: Although community participation has been identified as being important for improved and sustained health outcomes, designing and successfully implementing it in large scale public health programmes, including family planning and contraceptive (FP/C) service provision, remains challenging. Zambian participants in a multi-country project (the UPTAKE project) took part in the development of an intervention involving community and healthcare provider participation in FP/C services provision and uptake. This study reports key thematic areas identified by the study participants as critical to facilitating community participation in this intervention. Methods: This was an exploratory qualitative research study, conducted in Kabwe District, Central Province, in 2017. Twelve focus group discussions were conducted with community members (n = 114), two with healthcare providers (n = 19), and ten in-depth interviews with key community and health sector stakeholders. Data were analyzed using a thematic analysis approach. Results: Four thematic categories were identified by the participants as critical to facilitating community participation in FP/C services. Firstly, accountability in the recruitment of community participants and incorporation of community feedback in FP/C. programming. Secondly, engagement of existing community resources and structures in FP/C services provision. Thirdly, building trust in FP/C methods/services through credible community-based distributors and promotion of appropriate FP/C methods/services. Fourthly, promoting strategies that address structural failures, such as the feminisation of FP/C services and the lack FP/C services that are responsive to adolescent needs. Conclusions: Understanding and considering community members' and healthcare providers' views regarding contextualized and locally relevant participatory approaches, facilitators and challenges to participation, could improve the design, implementation and success of participatory public health programmes, including FP/C.

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“…Several contextual factors such as traditional marital norms and Christian values-particularly in Zambia, a nation constitutionally declared Christian, play a restrictive role in shaping adolescent fertility control and ordinarily opposing the global health view of fertility control which is rights-based, regardless of the user [12,15,16]. The two divergent views: the Christian and human rights-based moralities arouse heated discussions relating to SRH services [17], despite both being external to the local context and byproducts of modernity and globalization [18]. However, delaying the incidence of teenage pregnancy and early childbearing remains a priority to ensure the prevention and management of associated negative consequences of early pregnancy such as maternal mortality, morbidity, unsafe abortion, low birth-weight and infant mortality rates [13,14].…”

Section: Introductionmentioning

confidence: 99%

A critical discourse analysis of adolescent fertility In Zambia-a postcolonial perspective

Munakampe

Michelo

Zulu

2020

Preprint

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Background: Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia. Methods: A qualitative case study design was adopted, involving 33 individual interviews and 9 focus group discussions with adolescents and other key-informants such as parents, teachers and policymakers. Thematic analysis was used to analyze the data critically. Results: Adolescents’ age significantly reduced their access to Sexual and Reproductive Health, SRH services. Also, adolescent fertility discussions were influenced by marital norms and Christian beliefs, as well as health and rights values. While early marriage or child-bearing was discouraged, married adolescents and adolescents who had given birth before faced fewer challenges when accessing SRH information and services compared to their unmarried or nulliparous counterparts. Besides, the major influencers such as parents, teachers and health workers were also conflicted about how to package SRH information to young people, due to their varying roles in the community. Conclusion: The pluralistic view of adolescent fertility is fueled by “multiple consciousnesses”. This is evidenced by the divergent discourses that shape adolescent fertility control in Zambia, compounded by the disempowered position of adolescents in their communities. We assert that the competing moral worlds, correct in their own right, viewed within the historical and social context unearth significant barriers to the success of interventions targeted towards adolescents’ fertility control in Zambia, thereby propagating the growing problem of high adolescent fertility. This suggests proactive consideration of these discourses when designing and implementing adolescent fertility interventions.

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Situating the Mexico City Policy: what shapes contraceptive access and abortion?

Cited by 11 publications

References 10 publications

Reproductive health and the politics of abortion

Reproductive health and the politics of abortion

Facilitating community participation in family planning and contraceptive services provision and uptake: community and health provider perspectives

A critical discourse analysis of adolescent fertility In Zambia-a postcolonial perspective

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