New Publications on Contraceptive Use, Access, Abortion, Early Marriage, and Youth

Contraceptive Use

In “The Role of Social Support and Parity in Contraceptive Use in Cambodia,” researchers at the University of North Carolina and Population Services International find that partner support for contraception—or lack thereof—has a very strong influence on married Cambodian women’s contraceptive use.

 “Introducing Female Condoms to Female Sex Workers in Central America,” by Natasha Mack of Family Health International, et al., aims to help in-country program managers develop strategies for promoting the female condom as a means of protection against HIV infection. The authors conclude that uptake of the female condom among sex workers would likely increase if provisions were made for instructing women on its use in places where they would not feel stigmatized, and if supplies were easily and consistently available. Further, the authors note that even greater success for the female condom might be expected in Central America if promotion also occurred in the general population, as the sex workers themselves suggested.

Access

Hundreds of thousands of women die every year in childbirth or from pregnancy-related causes. Virtually all of these maternal deaths occur in poor countries. In order to reduce maternal deaths and improve the overall life chances of poor mothers, policy and programs must address poverty and gender inequality, two inter-related, root causes of maternal death. The new ICRW publication Targeting Poverty and Gender Inequality to Improve Maternal Health examines the ways in which poverty and gender inequality impact maternal mortality by creating barriers to maternal healthcare access and utilization. It also analyzes strategies designed to increase utilization to identify best practices.

“Access to maternal and perinatal health services: lessons from successful and less successful examples of improving access to safe delivery and care of the newborn,” Vincent De Brouwere and colleagues seek to address access issues for the avoidable 6.3 million perinatal deaths and half a million maternal deaths take place in developing countries. To promote the uptake of quality care, there are two possible approaches: influencing the demand and/or the supply of care. Five lessons emerged from experiences.

“Barriers to Formal Emergency Obstetric Care Services’ Utilization,” Hildah Essendi and colleagues rely on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. They found that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services.

Abortion

In “Self-Reported Abortion-Related Morbidity: A Comparison of Measures in Madhya Pradesh, India,” Laura Nyblade of the International Center for Research on Women et al., used a population-based survey rather than data from health facilities to capture the level of abortion-related morbidity in one of India’s poorest states. The researchers constructed two measures—one based on women’s reports of severity of complications and the other based on self-reported days of bed rest, a proxy for the degree of disruption of everyday life. Both measures found that the proportion of attempts resulting in severe morbidity was higher in rural than in urban areas. According to the authors, their findings demonstrate not only the high level of abortion-related morbidity in Madhya Pradesh, but the value of measuring morbidity in ways that capture both clinically observable symptoms and the effects of morbidity on women’s lives.

In “Self-reporting of induced abortion by women attending prenatal clinics in urban Nigeria,” Friday Okonofua and colleagues at the University of Benin find that induced abortion is highly prevalent in urban Nigeria, according to self-reports of women who were asked questions on abortion in the context of medical care.

Early Marriage

In “Associations Between Early Marriage and Young Women's Marital and Reproductive Health Outcomes,” K.G. Santhya and colleagues at the Population Council, New Delhi, analyzed data on Indian women aged 20–24 from a large-scale survey conducted in urban and rural areas of five states where early marriage is widespread. They found that young women who had married at age 18 or older were more likely than those who had married earlier to have been involved in planning their marriage, to reject wife beating, to have used contraceptives to delay their first pregnancy and to have had their first birth in a health facility. Compared with women who had married early, they were also less likely to have experienced physical or sexual violence in their marriage or to have had a miscarriage or a stillbirth. According to the authors, their findings underscore the need to build support within families for delaying marriage, to enforce existing laws barring early marriage and to build support for young women who wish to delay marriage. 

Youth

WHO Regional Office for Europe has released the publication Youth-friendly health policies and services in the European Region. It presents experiences of how health systems in Member States of the WHO European Region respond to the challenge of meeting the health and developmental needs of young people. The main aim is to facilitate experience-sharing and stimulate actions in countries.