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2.
Femina ; 48(11): 646-653, 20201130. graf, tab
Artigo em Português | LILACS | ID: biblio-1140180

RESUMO

Objetivo: O objetivo do estudo foi verificar a existência da objeção de consciência na atenção integral à saúde das vítimas de violência sexual, bem como conhecer a estrutura de atendimento das instituições credenciadas na rede de atenção à vítima de violência sexual no Estado de Minas Gerais. Métodos: Trata-se de um estudo de campo de caráter quantitativo, transversal, descritivo e analítico, com proposta de coleta de dados das instituições credenciadas ao atendimento às vítimas de violência sexual no estado. O instrumento foi entregue aos(às) coordenadores(a) desses serviços. Resultados: Verificou-se que 11% dos serviços não possuem médicos e 31% não fornecem treinamento para esse tipo de atendimento. Foi revelado que 85% dessas instituições já encontraram pacientes que desejam fazer o aborto legal, mas 83% delas não tiveram seu pedido atendido. Houve 60% da presença de objeção de consciência por parte de toda a equipe médica, sendo o principal motivo religioso (57%). Conclusão: O sistema de assistência no Estado não está preparado para o atendimento integral às vítimas de violência sexual, principalmente no quesito resolução do aborto legal, sendo a objeção de consciência o maior obstáculo. Faz-se necessária uma rede de referência e contrarreferência funcionante para amenizar esse problema tão sério e evidente. Espera-se que o resultado da pesquisa crie espaços de diálogo dentro do Estado que favoreçam ações adequadas sobre o aborto legal e respeitem o profissional médico se houver objeção de consciência.(AU)


Objective: The aim of this study was to verify the existence of conscientious objection to comprehensive health care for the victim of sexual violence, as well as to understand the service structure of institutions authorized in the health care system for victims of sexual violence in the state of Minas Gerais. Methods: This is a quantitative, cross-sectional, descriptive, and analytical field study aiming to collect data from institutions authorized to assist victims of sexual violence in the state. The instrument was handed in to the coordinators of these services. Results: It was found that 11% have no physician in service and that 31% had no training for this type of care. It was revealed that 85% of these institutions have already encountered patients wishing to have a legal abortion, but 83% of them have not had their request granted. There was a 60% presence of conscientious objection by the entire medical team, the main reason being religious (57%). Conclusion: The assistance system is not prepared for comprehensive care for victims of sexual violence, especially in terms of legal abortions, with conscientious objection being the main obstacle. A functional referral and counter-referral system is needed to alleviate such a serious and evident problem. It is hoped that the research results will promote dialogues in the state that favor appropriate actions on legal abortion, and respect the medical professional, in case of conscientious objection.(AU)


Assuntos
Humanos , Feminino , Gravidez , Bioética , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/ética , Aborto Legal/legislação & jurisprudência , Aborto Legal/ética , Instituições de Assistência Ambulatorial/ética , Brasil , Estudos Transversais , Recusa do Paciente ao Tratamento , Violência contra a Mulher
8.
Sex Reprod Health Matters ; 28(3): 1831717, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33073725

RESUMO

In recent decades, bold steps taken by the government of Nepal to liberalise its abortion law and increase the affordability and accessibility of safe abortion and family planning have contributed to significant improvements in maternal mortality and other sexual and reproductive health (SRH) outcomes. The Trump administration's Global Gag Rule (GGR) - which prohibits foreign non-governmental organisations (NGOs) from receiving US global health assistance unless they certify that they will not use funding from any source to engage in service delivery, counselling, referral, or advocacy related to abortion - threatens this progress. This paper examines the impact of the GGR on civil society, NGOs, and SRH service delivery in Nepal. We conducted 205 semi-structured in-depth interviews in 2 phases (August-September 2018, and June-September 2019), and across 22 districts. Interview participants included NGO programme managers, government employees, facility managers and service providers in the NGO and private sectors, and service providers in public sector facilities. This large, two-phased study complements existing anecdotal research by capturing impacts of the GGR as they evolved over the course of a year, and by surfacing pathways through which this policy affects SRH outcomes. We found that low policy awareness and a considerable chilling effect cut across levels of the Nepali health system and exacerbated impacts caused by routine implementation of the GGR, undermining the ecology of SRH service delivery in Nepal as well as national sovereignty.


Assuntos
Aborto Induzido/economia , Aborto Induzido/legislação & jurisprudência , Serviços de Planejamento Familiar/economia , Serviços de Planejamento Familiar/legislação & jurisprudência , Saúde Global , Política , Desenvolvimento Econômico , Feminino , Regulamentação Governamental , Direitos Humanos , Humanos , Internacionalidade , Entrevistas como Assunto , Nepal , Estados Unidos
11.
Sex Reprod Health Matters ; 28(3): 1794412, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32815492

RESUMO

In 2017, the Trump Administration reinstated and expanded the Global Gag Rule (GGR). This policy requires non-governmental organisations (NGOs) not based in the US to certify that they will not provide, counsel, refer, or advocate for abortion as a method of family planning in order to receive most categories of US global health assistance. Robust empirical evidence demonstrating the policy's impacts is acutely lacking. This paper describes the effects of the expanded GGR policy in Kenya eighteen months after its reinstatement. We conducted semi-structured interviews with purposively selected representatives of US- and non-US-based NGOs, as well as managers and health providers at public and private health facilities, between September 2018 and March 2019. Organisations reported critical funding loss as they were forced to choose between US government-funded projects and projects supporting safe abortion. This resulted in the fragmentation of sexual and reproductive health and HIV services, and closure of some service delivery programmes. At public and private health facilities, participants reported staffing shortages and increased stock-outs of family planning and safe abortion commodities. The expanded GGR's effects transcended abortion care by also disrupting collaboration and health promotion activities, strengthening opposition to sexual and reproductive health and rights in some segments of Kenyan civil society and government. Our findings indicate that the GGR exposes and exacerbates the weaknesses and vulnerabilities of the Kenyan health system, and illuminates the need for action to mitigate these harms.


Assuntos
Aborto Induzido/economia , Aborto Induzido/legislação & jurisprudência , Serviços de Planejamento Familiar/economia , Serviços de Planejamento Familiar/legislação & jurisprudência , Saúde Global , Política , Desenvolvimento Econômico , Feminino , Regulamentação Governamental , Direitos Humanos , Humanos , Internacionalidade , Entrevistas como Assunto , Quênia , Estados Unidos
13.
Sex Reprod Health Matters ; 28(3): 1794411, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32835637

RESUMO

The Trump Administration's Protecting Life in Global Health Assistance (PLGHA) significantly expands the "Global Gag Rule" - and, in so doing, weakens the global governance of abortion. By chilling debate, reducing transparency, ghettoising sexual and reproductive health and rights work, and interfering with research, PLGHA makes an already bad context demonstrably worse. Individual women suffer the most, as PLGHA inhibits ongoing efforts to reduce abortion-related morbidity and mortality.


Assuntos
Aborto Induzido/economia , Aborto Induzido/legislação & jurisprudência , Serviços de Planejamento Familiar/economia , Serviços de Planejamento Familiar/legislação & jurisprudência , Saúde Global , Política , Feminino , Regulamentação Governamental , Direitos Humanos , Humanos , Internacionalidade , Estados Unidos
14.
Sex., salud soc. (Rio J.) ; (35): 35-57, maio-ago. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1139635

RESUMO

Resumen Este artículo presenta un estudio sobre el primer símbolo transnacional del movimiento por el derecho al aborto en el Cono Sur: la "mano que vota" a favor del aborto legal. El emblema surge en Uruguay a comienzos de la década del 2000. Alrededor de 2010, el símbolo viró al color verde y fue adoptado por la Campaña Nacional por el Derecho al Aborto Legal, Seguro y Gratuito en Argentina. A partir de 2015, la mano que vota también acompañó el proceso que llevó a la legalización del aborto en tres causales en Chile. El análisis focaliza sobre rol de los símbolos y de los afectos en el activismo por el derecho al aborto. La mano que vota fue central para la construcción de identidad colectiva y sintonía política del movimiento. También este emblema logró imantar esperanzas asociadas con la democracia y un profundo sentido de la obstinación política. Los resultados se basan en el trabajo con diversos archivos y en conversaciones con informantes clave de Argentina, Chile y Uruguay.


Resumo Este artigo apresenta um estudo sobre o primeiro símbolo transnacional do movimento pelo direito ao aborto no Cone Sul: a "mão que vota" a favor do aborto legal. O emblema surgiu no Uruguai no início dos anos 2000. Por volta de 2010, o símbolo ficou verde e foi adotado pela Campanha Nacional pelo Direito ao Aborto Legal, Seguro e Gratuito na Argentina. A partir de 2015, a mão que vota também acompanhou o processo que levou à legalização do aborto em três casos no Chile. A análise enfoca o papel dos símbolos e emoções no ativismo pelo direito ao aborto. A mão que vota foi fundamental para a construção da identidade coletiva e sintonia política do movimento. Este emblema também conseguiu magnetizar esperanças associadas à democracia e um profundo senso de obstinação política. Os resultados são baseados em investigação em vários arquivos e conversas com informantes-chave da Argentina, Chile e Uruguai.


Abstract This article presents a study on the first transnational symbol of the movement for abortion rights in Latin America's Southern Cone: the "voting hand" for legal abortion. The emblem emerged in Uruguay at the beginning of the 2000s. Around 2010, the symbol turned green and was adopted by the National Campaign for the Right to Legal, Safe and Free Abortion in Argentina. As of 2015, the voting hand also accompanied the process that led to the legalization of abortion on three cases in Chile. The analysis focuses on the role of symbols and affects in the activism for abortion rights. The voting hand was central for the construction of a collective identity and political sintony in the movement. This emblem also magnetized hopes associated with democracy and a deep sense of political willfulness. Results are based in documentary research in various archives and in conversations with key informants from Argentina, Chile and Uruguay.


Assuntos
Humanos , Feminino , Gravidez , Identificação Social , Direitos da Mulher , Aborto Legal/legislação & jurisprudência , Feminismo , Direitos Sexuais e Reprodutivos , Ativismo Político , Política , Mudança Social , América do Sul , Aborto Induzido/legislação & jurisprudência , Democracia , Políticas Públicas de Saúde , Direitos Humanos
15.
Lancet Glob Health ; 8(9): e1152-e1161, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32710833

RESUMO

BACKGROUND: Unintended pregnancy and abortion estimates document trends in sexual and reproductive health and autonomy. These estimates inform and motivate investment in global health programmes and policies. Variability in the availability and reliability of data poses challenges for measuring and monitoring trends in unintended pregnancy and abortion. We developed a new statistical model that jointly estimated unintended pregnancy and abortion that aimed to better inform efforts towards global equity in sexual and reproductive health and rights. METHODS: We developed a model that simultaneously estimated incidence of unintended pregnancy and abortion within a Bayesian framework. Data on pregnancy intentions and abortion were compiled from country-based surveys, official statistics, and published studies found through a literature search, and we obtained data on livebirths from the World Population Prospects. We analysed results by World Bank income groups, Sustainable Development Goal regional groupings, and the legal status of abortion. FINDINGS: In 2015-19, there were 121·0 million unintended pregnancies annually (80% uncertainty interval [UI] 112·8-131·5), corresponding to a global rate of 64 unintended pregnancies (UI 60-70) per 1000 women aged 15-49 years. 61% (58-63) of unintended pregnancies ended in abortion (totalling 73·3 million abortions annually [66·7-82·0]), corresponding to a global abortion rate of 39 abortions (36-44) per 1000 women aged 15-49 years. Using World Bank income groups, we found an inverse relationship between unintended pregnancy and income, whereas abortion rates varied non-monotonically across groups. In countries where abortion was restricted, the proportion of unintended pregnancies ending in abortion had increased compared with the proportion for 1990-94, and the unintended pregnancy rates were higher than in countries where abortion was broadly legal. INTERPRETATION: Between 1990-94 and 2015-19, the global unintended pregnancy rate has declined, whereas the proportion of unintended pregnancies ending in abortion has increased. As a result, the global average abortion rate in 2015-19 was roughly equal to the estimates for 1990-94. Our findings suggest that people in high-income countries have better access to sexual and reproductive health care than those in low-income countries. Our findings indicate that individuals seek abortion even in settings where it is restricted. These findings emphasise the importance of ensuring access to the full spectrum of sexual and reproductive health services, including contraception and abortion care, and for additional investment towards equity in health-care services. FUNDING: UK Aid from the UK Government, Dutch Ministry of Foreign Affairs, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), and The Bill & Melinda Gates Foundation.


Assuntos
Aborto Induzido/legislação & jurisprudência , Aborto Induzido/estatística & dados numéricos , Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Gravidez não Planejada , Adolescente , Adulto , Teorema de Bayes , Feminino , Humanos , Pessoa de Meia-Idade , Modelos Estatísticos , Gravidez , Adulto Jovem
20.
Aust N Z J Public Health ; 44(5): 349-352, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32510724

RESUMO

OBJECTIVE: To measure public opinion about access to abortion in South Australia. METHODS: An online survey conducted in 2019. SPSS statistical package version 22 was used for data analysis, with data weighted by age, gender, and region. RESULTS: The majority (65%) of the 1,012 respondents supported the ready availability of abortion care and an additional 25% supported availability in certain circumstances. Most (70%) were unaware that abortion remains in criminal law and 80% supported decriminalisation. Support for safe access zones (88%) and the application of existing protections (69%) and obligations (94%) for conscientious objectors was high. A majority (63%) considered that later abortion should be available 'when the woman and her healthcare team decide it is necessary'. CONCLUSIONS: These results confirm the trend of increasing support for access to abortion and add two new insights. There was majority support for using existing general protections for the rights and obligations of those with a conscientious objection to abortion. Second, there was strong support for decisions about later abortion to be decided through normal clinical consultation. These results indicate general community approval of abortion being normalised as healthcare, with the safeguards and accountabilities that status entails. Implications for public health: These results invite repeal of special laws about abortion care, to enable better access.


Assuntos
Aborto Induzido/ética , Aborto Legal/legislação & jurisprudência , Acesso aos Serviços de Saúde/ética , Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde Materna/organização & administração , Opinião Pública , Aborto Induzido/legislação & jurisprudência , Aborto Legal/ética , Aborto Legal/estatística & dados numéricos , Adolescente , Adulto , Atitude do Pessoal de Saúde , Feminino , Acesso aos Serviços de Saúde/legislação & jurisprudência , Humanos , Gravidez , Serviços de Saúde Reprodutiva , Austrália do Sul , Saúde da Mulher , Direitos da Mulher , Adulto Jovem
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