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Sex Reprod Health Matters ; 28(2): 1781583, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32543338


The COVID-19 pandemic is not just a health crisis - it is a full-blown economic and social crisis that is impacting the lives and livelihoods of billions of people. This commentary examines the mutually dependent relationship between health security and universal health coverage (UHC), and how the longstanding underinvestment in both renders us all vulnerable. It also discusses the vulnerability of services for sexual and reproductive health and rights (SRHR) in times of crisis, which is compounded when these services are not included and well integrated into national UHC packages. It concludes with a call for stronger political leadership for UHC and SRHR as the global community strives to "build back better" after COVID-19.

Infecções por Coronavirus/epidemiologia , Nível de Saúde , Pneumonia Viral/epidemiologia , Cobertura Universal do Seguro de Saúde/organização & administração , Betacoronavirus , Acesso aos Serviços de Saúde/normas , Humanos , Pandemias , Política , Saúde Reprodutiva/normas , Direitos Sexuais e Reprodutivos/normas , Saúde Sexual/normas
Int J Gynaecol Obstet ; 149(1): 113-119, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32012258


Ensuring universal access to sexual and reproductive healthcare services is Target 3.7 of the United Nations Sustainable Development Goals (SDG). Refugee and migrant women and children are at particular risk of being forgotten in the global momentum to achieve this target. In this article we discuss the violations of sexual and reproductive health and rights (SRHR) of particular relevance to the refugee and migrant reality. We give context-specific examples of denial of health services to vulnerable groups; lack of dignity as a barrier to care; the vulnerability of adolescents; child marriage; weaponized rape; gender-based violence; and sexual trafficking. We discuss rights frameworks and models that are being used in response to these situations, as well as what remains to be done. Specifically, we call for obstetricians and gynecologists to act as individual providers and through their FIGO member societies to protect women's health and rights in these exposed settings.

Refugiados , Saúde Reprodutiva/normas , Direitos Sexuais e Reprodutivos/normas , Migrantes , Adolescente , Adulto , Criança , Feminino , Saúde Global , Ginecologia/normas , Humanos , Cooperação Internacional , Obstetrícia/normas , Saúde Sexual/normas , Desenvolvimento Sustentável , Saúde da Mulher
BMC Health Serv Res ; 19(1): 851, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31747914


BACKGROUND: Over time, the Brazilian health system, a growing country, has been developing to ensure good accessibility to health goods and services. This development is focusing on the principle of universality of access and completeness of health care. In this context, we aimed to evaluate the completeness of care and universality of access for women in their pregnancy and puerperal period in Ceará, Brazil. METHODS: A descriptive, cross-sectional study based on a quantitative approach, using information collected from the database of the regulation system of the state of Ceará and data from the Prenatal Monitoring System. The research population comprised of 1701 women who delivered a baby in an obstetric reference unit in the Health Macro-Region of Cariri, Ceará, Brazil from January to December 2015. RESULTS: There was a high rate of cesarean delivery (49.7%) and a high waiting time for access to high-risk delivery (32.6%) and neonatal intensive care unit (72.9%). There was also a low percentage (41.1%) of pregnant women undergoing an adequate number of prenatal consultations, dental care (20%), educational activities (15%), visits to the maternity ward (0.1%), laboratory tests of the third trimester (29.2%) and puerperal consultation (37.9%). CONCLUSIONS: It was concluded that the Maternal and Child Health Policy, especially the Rede Cegonha, which is still under development, does not ensure access and completeness of care for women during the prenatal, delivery, and puerperal periods, thus violating their reproductive rights. The results of this study allow a critical analysis by the academia and health managers in search of strategies to improve the services of Rede Cegonha in Brazil.

Acesso aos Serviços de Saúde/normas , Serviços de Saúde Materna/normas , Adulto , Brasil , Cesárea/estatística & dados numéricos , Criança , Estudos Transversais , Feminino , Política de Saúde , Humanos , Assistência Médica/normas , Cuidado Pós-Natal/normas , Período Pós-Parto/fisiologia , Gravidez , Complicações na Gravidez/terapia , Gestantes , Cuidado Pré-Natal/normas , Encaminhamento e Consulta , Direitos Sexuais e Reprodutivos/normas , Adulto Jovem
Rev. bioét. derecho ; (47): 109-117, nov. 2019. tab
Artigo em Português | IBECS | ID: ibc-184869


A saúde sexual e reprodutiva é um direito humano fundamental que se concretiza através dos Direitos Sexuais e Reprodutivos, e a esterilização voluntária é um método contraceptivo importante para a promoção do exercício desses direitos. Enquanto no Brasil, o legislador optou pela imposição de limites para sua realização, na Espanha, o regramento promoveu a igualdade entre as pessoas, respeitando a autodeterminação corporal, especialmente das mulheres. A partir desse panorama, pretende-se identificar e compreender quais fundamentos justificam (ou não) a imposição de limites para o acesso ao procedimento. Para esse fim, utilizar-se-ão as contribuições jus-filosóficas dos autores Ronald Dworkin e Jürgen Habermas, traçando um paralelo com o regramento espanhol sobre o tema

La salud sexual y reproductiva es un derecho humano fundamental que se concreta a través de los derechos sexuales y reproductivos, y la esterilización voluntaria es un método anticonceptivo importante para promover el ejercicio de estos derechos. Mientras que en Brasil el legislador optó por la imposición de límites para su realización, en España la norma promovió la igualdad entre las personas, respetando la autodeterminación del cuerpo, especialmente de las mujeres. A partir de este panorama, pretendemos identificar y comprender qué fundamentos justifican (o no) la imposición de límites para el acceso al procedimiento. Con este fin, se utilizarán las contribuciones jus-filosóficas de los autores Ronald Dworkin y Jürgen Habermas, trazando un paralelismo con la norma española sobre el tema

Sexual and reproductive health is a fundamental human right concretized through sexual and reproductive rights, whose exercise is also promoted by voluntary sterilization. In Brazil, while the lawmaker opted for the imposition of limits for the realization of this contraceptive method, in Spain, the law promoted equality among people, respecting body self-determination, especially of women. From this panorama, we intend to identify and understand which fundamentals justify (or not) the imposition of limits to access this procedure. Therefor, the jus-philosophical contributions of the authors Ronald Dworkin and Jürgen Habermas will be used, tracing a parallel with the Spanish law across this subject

La salut sexual i reproductiva és un dret humà fonamental que es concreta a través dels drets sexuals i reproductius, i l'esterilització voluntària és un mètode anticonceptiu important per a promoure l'exercici d'aquests drets. Mentre que al Brasil el legislador va optar per la imposició de límits per a la seva realització, a Espanya la norma va promoure la igualtat entre les persones, respectant l'autodeterminació del cos, especialment de les dones. A partir d'aquest panorama, pretenem identificar i comprendre quins fonaments justifiquen (o no) la imposició de límits per a l'accés al procediment. A aquest efecte, s'utilitzaran les contribucions jus-filosòfiques dels autors Ronald Dworkin i Jürgen Habermas, traçant un paral·lelisme amb la norma espanyola sobre el tema

Humanos , Esterilização Reprodutiva/legislação & jurisprudência , Esterilização Reprodutiva/métodos , Direitos Sexuais e Reprodutivos/normas , Brasil , Espanha , Direitos Humanos , 57358 , Direitos Sexuais e Reprodutivos/legislação & jurisprudência
Reprod Health ; 16(Suppl 1): 57, 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31138222


BACKGROUND: Extensive documentation exists on a range of negative sexual and reproductive health outcomes and rights violations occurring during humanitarian emergencies. We explore two central questions: Do existing policies, services, and research adequately address the SRH rights, priorities and HIV risks of adolescent girls and young women in emergency settings? What are the missed opportunities for holistically addressing the vulnerabilities experienced by those living with HIV during rapid onset disasters and long term, protracted emergencies? Authors review considerations informing real-time decision making, and highlight missed opportunities to apply a gendered lens in the delivery of AGYW-centered SRHR/HIV services. METHODS: A scoping review identified studies on HIV intervention and outcomes in emergency settings, published in the peer-reviewed literature (2002-2017). This exercise was complemented with a desk review of normative guidance, frameworks, and implementation guidelines on HIV and SRH in emergency responses, and by consultations with subject matter experts. RESULTS: The existing frameworks and guidance pay scant attention to the sexual reproductive health and rights of young women living with HIV (WLHIV), focusing mainly on prevention of mother to child transmission (PMTCT), antiretroviral therapy (ART), HIV testing services, and linkage to treatment services. Applying a gendered sexual and reproductive health lens to the response offers opportunities to identify critical implementation questions, and highlight promising practices, to better tailor current services for AGYW. CONCLUSIONS: A plurality of competing needs crowds out dedicated time and space to effectively integrate HIV and sexual and reproductive health interventions in emergency settings. Political will is required to advance multi-sectoral cooperation, through joint planning, rights-informed learning and integrative responses, and to promote creative solutions for ART continuation, drug supply and HIV testing, treatment and care. Recent advancements in policy and practice would suggest that a more AGYW-centered response is feasible.

Serviços de Saúde do Adolescente/organização & administração , Infecções por HIV/prevenção & controle , Política de Saúde , Serviços de Saúde Reprodutiva/organização & administração , Direitos Sexuais e Reprodutivos/legislação & jurisprudência , Direitos Sexuais e Reprodutivos/normas , Saúde Sexual , Adolescente , Adulto , Feminino , HIV/isolamento & purificação , Infecções por HIV/virologia , Necessidades e Demandas de Serviços de Saúde , Humanos , Metanálise como Assunto , Gravidez , Comportamento Sexual , Adulto Jovem
Violence Against Women ; 25(15): 1854-1877, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30758266


Financial abuse refers to men's control over money, assets, and women's education or paid work. As a corrective to existing undertheorization of men's (and their family's) abuse of and control over women's unpaid (domestic) labor, this article proposes a new conceptualization of economic abuse. Drawing upon life-history interviews with 41 South Asian women from the United Kingdom and India, this article explores control and abuse in relation to financial resources and women's paid work as well as unpaid work. It utilizes an intersectional perspective to explore how gender, migration status, race/ethnicity, and class can improve understanding of women's experiences as a continuum of economic abuse.

Economia , Direitos Sexuais e Reprodutivos/tendências , Problemas Sociais/tendências , Humanos , Índia , Direitos Sexuais e Reprodutivos/normas , Fatores Socioeconômicos , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos , Reino Unido
BMJ Sex Reprod Health ; 45(1): 61-67, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30622127


BACKGROUND: Reproductive control of women by others comprises a wide range of behaviours, from persuasion to pressure such as emotional blackmail, societal or family expectations, through to threats of or actual physical violence. It is defined as behaviours that interfere with women's reproductive autonomy as well as any actions that pressurise or coerce a woman into initiating or terminating a pregnancy METHOD: Narrative review based on a search of medical and social science literature. RESULTS: Reproductive control by others includes control or coercion over decisions about becoming pregnant and also about continuing or terminating a pregnancy. It can be carried out by intimate partners, the wider family, or as part of criminal behaviour. One form is contraceptive sabotage, which invalidates the consent given to sex. Contraceptive sabotage includes the newly-described behaviour of 'stealthing': the covert removal of a condom during sex. Reproductive control by others is separate from intimate partner violence but there are similarities and the phenomena overlap. Reproductive control by others is reported by as many as one quarter of women attending sexual and reproductive healthcare services. Those treating such women should be familiar with the concept and how to ameliorate its effects. Screening questions for its detection have been developed as well as interventions to reduce its risk. CONCLUSIONS: Reproductive control by others is common and those working in women's health should be familiar with the concept and with screening tools used to detect it.

Coerção , Direitos Sexuais e Reprodutivos/normas , Adulto , Epidemiologia/tendências , Feminino , Humanos , Gravidez , Direitos Sexuais e Reprodutivos/tendências , Autoeficácia , Comportamento Sexual
Reprod Health Matters ; 26(52): 1490624, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30070172


This roundtable discussion is the result of a research symposium entitled In Transition: Gender [Identity], Law & Global Health where participants took up the challenge to engage with the question: What will it take to ensure the sexual and reproductive health and rights (SRHR) of transgender populations across the globe? The barriers to overcome are fierce, and include not only lack of access to health services and insurance but also stigma and discrimination, harassment, violence, and violations of rights at every turn. Transgender people must of course lead any sort of initiatives to improve their lives, even as partnerships are needed to build capacity, translate lived experience into usable data, and to make strategic decisions. The SRHR of transgender people can only be addressed with attention to the social, cultural, legal, historical, and political contexts in which people are situated, with social, psychological, medical, and legal gender affirmation as a key priority shaping any intervention. Bringing together nine diverse yet complementary perspectives, our intent is to jumpstart a global and multigenerational conversation among transgender activists, lawyers, policy-makers, programmers, epidemiologists, economists, social workers, clinicians and all other stakeholders to help think through priority areas of focus that will support the needs, rights, and health of transgender populations. Making the changes envisioned here is possible but it will require not only the advocacy, policy, programmatic and research directions presented here but also struggle and action locally, nationally, and globally.

Saúde Global , Saúde Reprodutiva/normas , Direitos Sexuais e Reprodutivos/normas , Pessoas Transgênero , Atitude do Pessoal de Saúde , Países em Desenvolvimento , Educação em Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Humanos , Preconceito , Pesquisa/organização & administração , Estigma Social , Serviço Social/organização & administração
Reprod Health ; 15(1): 12, 2018 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-29370809


BACKGROUND: Adolescents have significant sexual and reproductive health needs. However, complex legal frameworks, and social attitudes about adolescent sexuality, including the values of healthcare providers, govern adolescent access to sexual and reproductive health services. These laws and social attitudes are often antipathetic to sexual and gender minorities. Existing literature assumes that adolescents identify as heterosexual, and exclusively engage in (heteronormative) sexual activity with partners of the opposite sex/gender, so little is known about if and how the needs of sexual and gender minority adolescents are met. METHODS: In this article, we have analysed data from fifty in-depth qualitative interviews with representatives of organisations working with adolescents, sexual and gender minorities, and/or sexual and reproductive health and rights in Malawi, Mozambique, Namibia, Zambia and Zimbabwe. RESULTS: Sexual and gender minority adolescents in these countries experience double-marginalisation in pursuit of sexual and reproductive health services: as adolescents, they experience barriers to accessing LGBT organisations, who fear being painted as "homosexuality recruiters," whilst they are simultaneously excluded from heteronormative adolescent sexual and reproductive health services. Such barriers to services are equally attributable to the real and perceived criminalisation of consensual sexual behaviours between partners of the same sex/gender, regardless of their age. DISCUSSION/ CONCLUSION: The combination of laws which criminalise consensual same sex/gender activity and the social stigma towards sexual and gender minorities work to negate legal sexual and reproductive health services that may be provided. This is further compounded by age-related stigma regarding sexual activity amongst adolescents, effectively leaving sexual and gender minority adolescents without access to necessary information about their sexuality and sexual and reproductive health, and sexual and reproductive health services.

Serviços de Saúde do Adolescente/provisão & distribução , Serviços de Saúde do Adolescente/normas , Acesso aos Serviços de Saúde , Serviços de Saúde Reprodutiva/provisão & distribução , Educação Sexual , Minorias Sexuais e de Gênero , Adolescente , Comportamento do Adolescente , Serviços de Saúde do Adolescente/organização & administração , Serviços de Saúde do Adolescente/estatística & dados numéricos , África Austral/epidemiologia , Atitude Frente a Saúde , Feminino , Acesso aos Serviços de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Homossexualidade , Humanos , Malaui/epidemiologia , Masculino , Moçambique/epidemiologia , Namíbia/epidemiologia , Serviços de Saúde Reprodutiva/organização & administração , Serviços de Saúde Reprodutiva/normas , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Direitos Sexuais e Reprodutivos/normas , Educação Sexual/legislação & jurisprudência , Educação Sexual/organização & administração , Educação Sexual/normas , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Estigma Social , Zâmbia/epidemiologia , Zimbábue/epidemiologia
Cult. cuid ; 21(48): 178-189, mayo-ago. 2017. graf, ilus
Artigo em Português | IBECS | ID: ibc-167399


Objetivos: identificar registros midiáticos da comunicação impressa que representem a paternidade, e comentar como eles apresentam o pai nas proximidades de sua data comemorativa. Método: estudo exploratório, realizado por análise documental, por meio do jornal "O GLOBO", no período de 01 a 11 de agosto de 2013, dias que antecederam a comemoração do Dia dos Pais. Resultado: 106 registros midiáticos foram identificados, sendo 66,26% de publicidades e 37,73% de reportagens. A figura paterna apareceu em todos os dias da delimitação temporal. Discussão: a paternidade ocorreu em meio a questões socioculturais e de gênero que permitiram perceber a figura de um pai atualmente mais afetivo e envolvido no cuidado com o filho. Conclusão: Existe investimento empresarial em torno da imagem paterna, no entanto, não só fatores comerciais, mas também culturais e sociais influenciam no exercício da paternidade (AU)

Objetivos: identificar los registros mediáticos de los medios de comunicación impresa que representen la paternidad y analizar los comentarios acerca de día del padre. Método: estudio exploratorio realizado por análisis documental, en el periódico "O Globo" en período de 01 a 11 de agosto de 2013, día que antecede a la conmemoración al día de los padres. Resultado: 106 registros mediáticos fueron identificados, siendo 66,73% de reportajes. La figura paterna apareció en todos los días de la delimitación temporal. Discusión: la paternidad ocurrió en medio a cuestiones socioculturales y de género que permitieron percibir la figura padre actualmente más afectuoso e involucrado en el cuidado del el hijo. Conclusión: Existe incidencia empresarial en la imagen paterna, sin embargo, no solo factores comerciales sino también culturales y sociales influyen en el ejercicio de la paternidad (AU)

Aim: to identify the media records of the press communication representing paternity and to comment how they represent the father approaching his commemorative day. Method: exploratory study, carried out through documental analysis, by means of "O GLOBO" newspaper, from August 01 to 11, 2013, some days before the Father's day. Result: 106 media records were identified: 66,26% advertising records and 37,73% reports. The father figure appeared on every day of this time delimitation. Discussion: paternity occurred amidst sociocultural and gender issues that permitted to perceive today a father figure more affective and involved on the child care. Conclusion: There is a business investment around the father figure, nevertheless, not only commercial factors, but also cultural and social ones influence on practicing paternity (AU)

Humanos , Masculino , Paternidade , Meios de Comunicação/ética , Meios de Comunicação/normas , Gênero e Saúde , Direitos Sexuais e Reprodutivos/legislação & jurisprudência , Direitos Sexuais e Reprodutivos/normas , Publicidade/métodos , Direitos Sexuais e Reprodutivos/tendências , Pesquisa Qualitativa
Rev. medica electron ; 39(4): 933-946, jul.-ago. 2017.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-902217


En México el reconocimiento a los derechos de las mujeres ha transitado un largo camino, acompañado muchas veces de experiencias difíciles para hacerlos valer. Desde 1930 se lucha por el reconocimiento de dichos derechos, se han signado ordenamientos, leyes nacionales e internacionales que norman todo a lo que las mujeres tienen acceso. Sin embargo, los estudios, encuestas y denuncias demuestran lo contrario. Este artículo abordó la problemática que las mujeres indígenas viven en México para que sean respetados y reconocidos sus derechos, específicamente los reproductivos y, particularmente, la esterilización impuesta, que además de violar su derecho a decidir por las instituciones encargadas de cuidar su salud, les genera problemas ginecológicos y rechazo por su pareja (AU).

Women's rights recognition in Mexico has gone through a long way, accompanied many times by difficult experiences to make them true. The fights for the recognition of those rights date back to 1930. Orders, national and international laws have been signed ruling all the rights to which women have access. However, studies, surveys and reports prove the entire contrary. This article approaches the problems affronted by the indigenous women who live in Mexico for the recognition and respect of their rights specially the reproductive ones and, particularly, the imposed sterilization, that besides the violation of their rights to decide from the part of the institutions in charge of taking care for their health, causes them gynecological problems and their couples rejection (AU).

Humanos , Masculino , Feminino , Direitos da Mulher/história , Violência Étnica/prevenção & controle , Literatura de Revisão como Assunto , Direitos Sexuais e Reprodutivos/história , Direitos Sexuais e Reprodutivos/legislação & jurisprudência , Direitos Sexuais e Reprodutivos/normas , Violência Étnica/tendências , Violência de Gênero/prevenção & controle , Violência de Gênero/tendências , México
J Adolesc Health ; 60(2S2): S10-S14, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28109334


Sexual and reproductive health and rights have gained prominence in the HIV response. The role of sexual and reproductive health in underpinning a successful approach to HIV prevention, treatment, care, and services has increasingly been recognized. However, the "second R," referring to sexual and reproductive rights, is often neglected. This leads to policies and programs which both fail to uphold and fulfill these rights and which fail to meet the needs of those most affected by HIV by neglecting to take account of the human right-based barriers and challenges they face. In this commentary, the authors draw on the approach and practical experiences of the Link Up program, and the findings of a global consultation led for and by young people living with and most affected by HIV, to present a five-point framework to improve programming and health outomces by better protecting, respecting, and fulfilling the sexual health and reproductive rights of young people living with and most vulnerable to HIV.

Acesso aos Serviços de Saúde/normas , Saúde Reprodutiva/normas , Direitos Sexuais e Reprodutivos/normas , Saúde Sexual/normas , Adolescente , Feminino , Saúde Global , Infecções por HIV/psicologia , Humanos , Masculino , Gravidez , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Adulto Jovem
Cuad. bioét ; 26(87): 311-323, mayo-ago. 2015.
Artigo em Espanhol | IBECS | ID: ibc-144151


Es indudable la marcada preocupación que existe en la actualidad por la protección de la salud de la mujer y la defensa de su dignidad y derechos. Este creciente interés incluye la concepción y tratamiento que se dé a su salud sexual y reproductiva. En este artículo se lleva a cabo una exposición de la legislación nacional concerniente a aspectos relativos a la atención y cuidado de la salud sexual y reproductiva femenina así como un análisis de los presupuestos que avalan la normativa citada. La finalidad que se pretende es doble: por un lado, señalar los aspectos positivos que derivan del avance de las ciencias biomédicas en estos temas. Y, por otro lado, indicar los puntos que hoy en día son objeto de debate y requieren, en mi opinión, de una reflexión serena

This article will examine how and to what extent advances in biomedical sciences have played a role in transforming the status of women. It will highlight the positive aspects of these transformations but it will also examine the issues which are currently debated and which, in my opinion, require calm and considered reflection

Feminino , Humanos , Masculino , Direitos Sexuais e Reprodutivos/ética , Direitos Sexuais e Reprodutivos/estatística & dados numéricos , Direitos Sexuais e Reprodutivos/normas , Saúde Sexual , Identidade de Gênero , Direitos Sexuais e Reprodutivos/legislação & jurisprudência , Direitos Sexuais e Reprodutivos/tendências