Progress towards sustainable development goals related to sexual health.

Achieving the sexual health components of sexual and reproductive health and rights as outlined in the sustainable development goals (SDGs) is integral to overall physical and mental well-being and a core part of universal health coverage. However, tracking national and global progress towards advancing the sexual health and rights of people is challenging because of the paucity of indicators to examine many of its components. To assess the state of sexual health in populations, determine service provision needs, evaluate the effectiveness of health system interventions and monitor progress in optimizing health, a comprehensive set of indicators is needed to cover every component of sexual health.

Measurement and conceptualization of male involvement in family planning: a bibliometric analysis of Africa-based studies.

Background: Male involvement in Family Planning (FP) is an exercise of men's sexual and reproductive health rights. However, the measurement of male involvement has been highly inconsistent and too discretional in FP studies. As a result, we used bibliometric tools to analyze the existing measures of male involvement in FP and recommend modifications for standard measures.

Quality of information offered to women by drug sellers providing medical abortion in Nigeria: Evidence from providers and their clients.

Background: Evidence confirmed that the demand for medical abortion (MA) increased significantly during the COVID-19 outbreak in many developing countries including Nigeria. In an abortion-restrictive setting like Nigeria, local pharmacies, and proprietary patent medicine vendors (PPMVs) continue to play a major role in the provision of MA including misoprostol. There is the need to understand these providers' knowledge about the use of misoprostol for abortion and the quality of information they provide to their clients.

Key drivers of fertility levels and differentials in India, at the national, state and population subgroup levels, 2015-2016: An application of Bongaarts' proximate determinants model.

Objectives: The transition to small family size is at an advanced phase in India, with a national TFR of 2.2 in 2015-16. This paper examines the roles of four key determinants of fertility-marriage, contraception, abortion and postpartum infecundability-for India, all 29 states and population subgroups.

The health system costs of post abortion care in Tanzania.

Background: Unsafe abortion is common in Tanzania. Currently, postabortion care (PAC) is legally provided, but there is little information on the national cost. We estimated the health system costs of offering PAC in Tanzania in 2018, at existing levels of care and when hypothetically expanded to meet all need.

Online Abortion Drug Sales in Indonesia: A Quality of Care Assessment.

This study sought to understand the experience of buying misoprostol online for pregnancy termination in Indonesia. We conducted a mystery client study August through October, 2019. Interactions were analyzed quantitatively and qualitatively, along with the contents of the packages.

The Health System Costs of Postabortion Care in Senegal.

Context: Unsafe abortion is common in Senegal, but postabortion care (PAC) is not accessible to some women who need it, and the cost to the health care system of providing PAC is unknown.

Methods: The cost to Senegal's health system of providing PAC in 2016-at existing service levels and if access were hypothetically expanded-was estimated using the Post-Abortion Care Costing Methodology, a bottom-up, ingredients-based approach. From September 2016 to January 2017, face-to-face interviews were conducted with PAC providers and facility administrators at a national sample of 41 health facilities to collect data on the direct and indirect costs of care provision, as well as the fees charged to patients.

Women's self-reported experiences using misoprostol obtained from drug sellers: a prospective cohort study in Lagos State, Nigeria.

Objectives: This study aimed to assess the safety and effectiveness of self-managed misoprostol abortions obtained outside of the formal health system in Lagos State, Nigeria.

Design: This was a prospective cohort study among women using misoprostol-containing medications purchased from drug sellers. Three telephone-administered surveys were conducted over 1 month.

Women's abortion seeking behavior under restrictive abortion laws in Mexico.

Abortion is regulated in Mexico at the state level, and it is permitted under certain criteria in all 32 states, except in Mexico City where first-trimester abortion is decriminalized. Yet, more than a million abortions occur in Mexico each year. But most terminations occurring outside of Mexico City are clandestine and unsafe due to profound stigma against the procedure, lack of trained providers, lack of knowledge of where to find a safe abortion and poor knowledge of the laws.

Comparing women's financial costs of induced abortion at a facility vs. seeking treatment for complications from unsafe abortion in Zambia.

Although abortion is legal in Zambia under a variety of broad conditions, unsafe abortion remains common. The purpose of this project was to compare the financial costs for women when they have an induced abortion at a facility, with costs for an induced abortion outside a facility, followed by care for abortion-related complications. We gathered household wealth data at one point in time (T1) and longitudinal qualitative data at two points in time (T1 and T2, three-four months later), in Lusaka and Kafue districts, between 2014 and 2015.

Estimating abortion incidence among adolescents and differences in postabortion care by age: a cross-sectional study of postabortion care patients in Uganda.

Objectives: To provide the first estimate of adolescents' abortion incidence in Uganda and to assess differences in the abortion experiences and morbidities of adolescent and nonadolescent postabortion care (PAC) patients.

Study Design: We used the age-specific Abortion Incidence Complications Method, drawing from three surveys conducted in Uganda in 2013: a nationally representative Health Facilities Survey (n=418), a Health Professionals Survey (n=147) and a Prospective Morbidity Survey of PAC patients (n=2169). Multivariable logistic and Cox proportional hazard models were used to compare adolescent and nonadolescent PAC patients on dimensions including pregnancy intention, gestational age, abortion safety, delays to care, severity of complications and receipt of postabortion family planning.

The Severity and Management of Complications Among Postabortion Patients Treated in Kinshasa Health Facilities.

Context: Unsafe abortion is common in Kinshasa, which contributes to high rates of maternal morbidity and mortality. Little is known about the complications and treatment experienced by women seeking postabortion care at health facilities in the city.

Methods: Data from 867 women admitted to a sample of health facilities providing postabortion care in Kinshasa in 2016 were drawn from a Prospective Morbidity Survey.

Setting the research agenda for induced abortion in Africa and Asia.

Provision of safe abortion is widely recognized as vital to addressing the health and wellbeing of populations. Research on abortion is essential to meet the UN Sustainable Development Goals. Researchers in population health from university, policy, and practitioner contexts working on two multidisciplinary projects on family planning and safe abortion in Africa and Asia were brought together for a workshop to discuss the future research agenda on induced abortion.

Playing it Safe: Legal and Clandestine Abortions Among Adolescents in Ethiopia.

Purpose: The 2005 expansion of the Ethiopian abortion law provided minors access to legal abortions, yet little is known about abortion among adolescents. This paper estimates the incidence of legal and clandestine abortions and the severity of abortion-related complications among adolescent and nonadolescent women in Ethiopia in 2014.

Methods: This paper uses data from three surveys: a Health Facility Survey (n = 822) to collect data on legal abortions and postabortion complications, a Health Professionals Survey (n = 82) to estimate the share of clandestine abortions that resulted in treated complications, and a Prospective Data Survey (n = 5,604) to collect data on abortion care clients.

The incidence of induced abortion in Kinshasa, Democratic Republic of Congo, 2016.

Background: In the Democratic Republic of Congo, the penal code prohibits the provision of abortion. In practice, however, it is widely accepted that the procedure can be performed to save the life of a pregnant woman. Although abortion is highly restricted, anecdotal evidence indicates that women often resort to clandestine abortions, many of which are unsafe.

Global, regional, and subregional classification of abortions by safety, 2010-14: estimates from a Bayesian hierarchical model.

Background: Global estimates of unsafe abortions have been produced for 1995, 2003, and 2008. However, reconceptualisation of the framework and methods for estimating abortion safety is needed owing to the increased availability of simple methods for safe abortion (eg, medical abortion), the increasingly widespread use of misoprostol outside formal health systems in contexts where abortion is legally restricted, and the need to account for the multiple factors that affect abortion safety.

Methods: We used all available empirical data on abortion methods, providers, and settings, and factors affecting safety as covariates within a Bayesian hierarchical model to estimate the global, regional, and subregional distributions of abortion by safety categories.

Changes in Morbidity and Abortion Care in Ethiopia After Legal Reform: National Results from 2008 and 2014.

Context: In Ethiopia, liberalization of the abortion law in 2005 led to changes in abortion services. It is important to examine how levels and types of abortion care-i.e.

The Estimated Incidence of Induced Abortion in Ethiopia, 2014: Changes in the Provision of Services Since 2008.

Context: In 2005, Ethiopia's parliament amended the penal code to expand the circumstances in which abortion is legal. Although the country has expanded access to abortion and postabortion care, the last estimates of abortion incidence date from 2008.

Methods: Data were collected in 2014 from a nationally representative sample of 822 facilities that provide abortion or postabortion care, and from 82 key informants knowledgeable about abortion services in Ethiopia.

Contraceptive Failure in the United States: Estimates from the 2006-2010 National Survey of Family Growth.

Context: Contraceptive failure rates measure a woman's probability of becoming pregnant while using a contraceptive. Information about these rates enables couples to make informed contraceptive choices. Failure rates were last estimated for 2002, and social and economic changes that have occurred since then necessitate a reestimation.

Incidence of Induced Abortion in Uganda, 2013: New Estimates Since 2003.

Background: In Uganda, abortion is permitted only when the life of a woman is in danger. This restriction compels the perpetuation of the practice in secrecy and often under unsafe conditions. In 2003, 294,000 induced abortions were estimated to occur each year in Uganda.

Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends.

Background: Information about the incidence of induced abortion is needed to motivate and inform efforts to help women avoid unintended pregnancies and to monitor progress toward that end. We estimate subregional, regional, and global levels and trends in abortion incidence for 1990 to 2014, and abortion rates in subgroups of women. We use the results to estimate the proportion of pregnancies that end in abortion and examine whether abortion rates vary in countries grouped by the legal status of abortion.

Insights from an expert group meeting on the definition and measurement of unsafe abortion.

Until recently, WHO operationally defined unsafe abortion as illegal abortion. In the past decade, however, the incidence of abortion by misoprostol administration has increased in countries with restrictive abortion laws. Access to safe surgical abortions has also increased in many such countries.