Exploring women's knowledge of abortion legality and association with source of abortion care using population-based survey data in Côte d'Ivoire and Ghana.

Background: Knowledge of the conditions under which abortion is legal is important so that people can advocate for their right to abortion care. Yet minimal research has explored the association between women's knowledge of abortion legality and the induced abortion care they receive, particularly using population-based survey data.

Methods: Using national survey data collected by Performance Monitoring for Action (PMA) in Côte d'Ivoire and Ghana, we aimed to compare the prevalence of accurate knowledge of abortion legality, factors associated with knowledge of the law, and the association between knowledge of abortion legality and the source of women's induced abortion care in these two settings.

Challenges and Opportunities to Advance Adolescent Health Measurement in Armenia: Alignment Between Global Priority Indicators and National Policies, and Feasibility of Collecting Sexual, Reproductive, and Mental Health Indicators.

Purpose: To assess alignment of the Global Action for Measurement of Adolescent health (GAMA) draft adolescent health indicators with national policies and explore challenges and opportunities for collecting data on adolescent sexual, reproductive, and mental health in Armenia.

Methods: We reviewed Armenia's national laws, decrees, policies, strategies, and programs for content related to the draft indicators. We conducted three focus group discussions with government and nongovernmental stakeholders and youth representatives on the feasibility of collecting the draft indicators, and analyzed the discussion segments related to sexual, reproductive, and mental health indicators.

Exploring a Preliminary Set of Indicators to Measure Adolescent Health: Results From a 12-Country Feasibility Study.

Purpose: To explore data availability, perceived relevance, acceptability and feasibility of implementing 52 draft indicators for adolescent health measurement in different countries globally.

Methods: A mixed-methods, sequential explanatory study was conducted in 12 countries. An online spreadsheet was used to assess data availability and a stakeholder survey to assess perceived relevance, acceptability, and feasibility of implementing each draft indicator proposed by the Global Action for Measurement of Adolescent health (GAMA).

Towards Harmonized Adolescent Health Measurement: Assessing Alignment Between Current Recommendations and the Global Action for Measurement of Adolescent Health-Recommended Indicators.

Purpose: This study identified alignment of indicators across different initiatives and data collection instruments as a foundation for future harmonization of adolescent health measurement.

Methods: Using the Global Action for Measurement of Adolescent health (GAMA) recommended indicators as the basis for comparison, we conducted a desk review of 14 global-level initiatives, such as the Sustainable Development Goals and the Global Strategy for Women's, Children's and Adolescents' Health, and five multicountry survey programs, such as the Multiple Indicator Cluster Surveys and the Global school-based Student Health Survey. We identified initiative and survey indicators similar to a GAMA indicator, deconstructed indicators into standard elements to facilitate comparison, and assessed alignment to the corresponding GAMA indicator across each of the elements.

An arterial access system for targeted chemotherapy delivery and arterial-arterial extracorporeal recirculation for 'end stage' peripheral vascular disease.

Background: Vascular access via a single arterial catheter for targeted chemotherapy delivery has difficulties with concentration, dilution, drug retention, plasma binding, and lack of control of the tumour microcirculation. An implantable arterial access system to accommodate multi-catheter access was developed address these problems. The system was also adapted for isolated arterial-to-arterial extracorporeal suprasystolic perfusion for end stage peripheral vascular disease.

Contraceptive and abortion practices of young Ghanaian women aged 15-24: evidence from a nationally representative survey.

Background: Young Ghanaian women experience high rates of unmet need for contraception and unintended pregnancy, and face unique barriers to accessing sexual and reproductive health services. This study provides a comprehensive national analysis of young women's contraceptive and abortion practices and needs.

Methods: In 2018, we conducted a nationally representative survey of women aged 15-49, including 1039 women aged 15-24.

Prevalence and Correlates of Perceived Infertility in Ghana.

Perceived infertility is an understudied phenomenon in low- and middle-income countries, where biomedical infertility can have severe consequences, particularly for women. We conducted a nationally representative survey of Ghanaian women, estimated the prevalence of and reasons for perceived infertility, and assessed factors associated with higher levels of perceived infertility using a partial proportional odds model. Among 4,070 women, 13 percent believed they were "very likely" to have difficulty getting pregnant when they wanted to, 21 percent believed this was "somewhat likely," and 66 percent believed this was "not at all likely.

Novel approaches to estimating abortion incidence.

Background: In countries where abortion is legally restricted or clandestine, estimates of abortion incidence are needed in order to bring attention to the reality of this practice. Innovations in methods for estimating stigmatized behaviors, coupled with changes in the conditions under which women obtain abortions, prompt us to review new approaches to estimating abortion incidence and propose innovations in this field.

Methods: We discuss five approaches for yielding accurate estimates in countries with restrictive abortion laws.

Challenges to implementing national comprehensive sexuality education curricula in low- and middle-income countries: Case studies of Ghana, Kenya, Peru and Guatemala.

School-based comprehensive sexuality education (CSE) can help adolescents achieve their full potential and realize their sexual and reproductive health and rights. This is particularly pressing in low- and middle-income countries (LMICs), where high rates of unintended pregnancy and STIs among adolescents can limit countries' ability to capitalize on the demographic dividend. While many LMICs have developed CSE curricula, their full implementation is often hindered by challenges around program planning and roll-out at the national and local level.

Postpartum Contraception in Northern Tanzania: Patterns of Use, Relationship to Antenatal Intentions, and Impact of Antenatal Counseling.

In Tanzania, unmet need for contraception is high, particularly in the postpartum period. Contraceptive counseling during routine antenatal HIV testing could reach 97 percent of pregnant women with much-needed information, but requires an understanding of postpartum contraceptive use and its relationship to antenatal intentions. We conducted a baseline survey of reproductive behavior among 5,284 antenatal clients in Northern Tanzania, followed by an intervention offering contraceptive counseling to half the respondents.

Incidence of Induced Abortion and Post-Abortion Care in Tanzania.

Background: Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence.

Objectives: To provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar).

Estimates of the incidence of induced abortion and consequences of unsafe abortion in Senegal.

Context: Abortion is highly restricted by law in Senegal. Although women seek care for abortion complications, no national estimate of abortion incidence exists.

Methods: Data on postabortion care and abortion in Senegal were collected in 2013 using surveys of a nationally representative sample of 168 health facilities that provide postabortion care and of 110 professionals knowledgeable about abortion service provision.

Bucking social norms: examining anomalous fertility aspirations in the face of HIV in Lusaka, Zambia.

In settings of high fertility and high HIV prevalence, individuals are making fertility decisions while simultaneously trying to avoid or manage HIV. We sought to increase our understanding of how individuals dually manage HIV risk while attempting to achieve their fertility goals as part of the project entitled HIV Status and Achieving Fertility Desires conducted in Zambia in 2011. Using multivariate regression to predict fertility patterns based on socio-demographic characteristics for respondents from facility-based and community-based surveys, we employed Anomalous Case Analysis (ACA) whereby in-depth interview respondents were selected from the groups of outliers amongst the survey respondents who reported lower or higher fertility preferences than predicted as well as those who adhered to predicted patterns, and lived in Lusaka (n=45).

Differences in unintended pregnancy, contraceptive use and abortion by HIV status among women in Nigeria and Zambia.

Context: Sub-Saharan Africa is burdened by high rates of unintended pregnancy and HIV. Yet little is known about the relationship between these two health risks in the region. Understanding the associations between HIV status and pregnancy decision making may benefit strategies to reduce unintended pregnancy.

Risk factors for repeat abortion and implications for addressing unintended pregnancy in Vietnam.

Objective: To determine predictors of repeat abortion in 3 provinces in Vietnam.

Methods: In a cross-sectional study between August and December 2011, women who underwent abortion were interviewed after the procedure in 62 public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City (HCMC). Information on sociodemographic factors, contraceptive and reproductive history and intentions, and opinions and experience of abortion services was collected.

Vocal local versus pharmacological treatments for pain management in tubal ligation procedures in rural Kenya: a non-inferiority trial.

Background: Vocal local (VL) is a non-pharmacological pain management technique for gynecological procedures. In Africa, it is usually used in combination with pharmacological analgesics. However, analgesics are associated with side-effects, and can be costly and subject to frequent stock-outs, particularly in remote rural settings.

The impact of antenatal HIV diagnosis on postpartum childbearing desires in northern Tanzania: a mixed methods study.

With the expansion of routine antenatal HIV testing, women are increasingly discovering they are HIV-positive during pregnancy. While several studies have examined the impact of HIV on childbearing in Africa, few have focused on the antenatal/postpartum period. Addressing this research gap will help tailor contraceptive counseling to HIV-positive women's needs.

Reproductive behaviour and HIV status of antenatal clients in northern Tanzania: opportunities for family planning and preventing mother-to-child transmission integration.

Objectives: To examine reproductive and contraceptive history and intentions by HIV status among women at antenatal clinics to help inform initiatives to integrate family planning into antenatal/preventing mother-to-child transmission services in Mwanza region, Tanzania.

Design: A questionnaire survey was carried out in antenatal clinics in Mwanza region, Tanzania in 2007-2008.

Methods: : We interviewed 5284 pregnant women attending 15 antenatal clinics offering HIV testing in Mwanza City and Magu district, northern Tanzania.