The Center for International Reproductive Health Training at the University of Michigan (CIRHT) partners with academic institutions in developing countries to strengthen capacity for life-saving reproductive health services through the integration of competency-based pre-service training in Family Planning and Comprehensive Abortion Care, revamping research culture and improving the quality of care.

This news review is one way we hope to keep an ongoing conversation with our partners and the global reproductive health community. (Hyperlinks in the text lead to relevant articles.)
The Center for International Reproductive Health (CIRHT) at the University of Michigan will be well-represented at the upcoming 2018 Consortium of Universities for Global Health (CUGH) annual conference. Thirteen abstracts covering a range of topics from implementing quality improvement and pre-service education programs to contraception and abortion care from CIRHT staff in Michigan and Ethiopia and five partner universities throughout Ethiopia have been accepted for presentation at the annual conference.
The Value of Family Planning
The UK Department for International Development (DFID) issued a tidy summary of the value of money spent on family planning : £225 million through 2022, “will every year help save the lives of over 6,000 women by preventing maternal deaths – that’s one woman every 90 minutes; support nearly 20 million women to receive voluntary contraceptives through family planning services; help avert 6 million unintended pregnancies; and help prevent the trauma of 75,000 stillbirths and nearly 44,000 new-born deaths.”

FP advocates in Senegal, where 90 percent of the population is Muslim, are finding key allies in imams , using the idea that “modern contraception is an extension of traditional Islamic practices… Advocates say that since imams started getting involved, birth control is beginning to enjoy far wider social acceptance. Since 2011, the number of married Senegalese women  using modern contraceptives has doubled from 12 percent to about 23 percent.”

A UN 2012 report declared “ Contraception is a Human Right ” -- yet “the UN estimates that the lack of availability of contraception services affect 11 percent of sexually active women worldwide between 15 and 49 who either don’t want any more children or would like to delay the birth of their next child. In sub-Saharan Africa, this figure rises to 25 percent.”

Conflicting messages emanating from the Kenyan press: An editorial calls for greater emphasis on preventing teen pregnancy through “comprehensive sexual and reproductive health education and information into the school curriculum and other platforms.” Nevertheless, one MP called for his constituents to ignore family planning , using the argument, “It's good to give birth to many children since you don't know who will help you in future. You might give birth to one child who may end up being a thief.”

The East African Legislative Assembly is looking to address all of these issues, including safe abortion access, in its Sexual Reproductive Health and Rights bill .  

Calls to Action
Individual Action for Change

Two studies show the importance of reaching individuals with information and counseling. From the Guttmacher Institute: “ Post-abortion contraception counseling has the potential to help non-users [of contraception] find methods that meet their preferences and to help women better use their current methods.” And the corollary, threats to informed consent mean “ restricting comprehensive counseling and referrals for all pregnancy options [which] seriously jeopardizes women’s health and well-being.”

And individuals can effect change. Pathfinder International and K4Health highlight Marie Musifu a girl from DRC who is “ fighting for young people’s sexual and reproductive health and rights ” by starting youth clubs to discuss family planning, an effort which has led the government to launch “the first national platform for including the youth leaders in decision-making about adolescent and youth sexual and reproductive health.”

A story from Girl’s Globe about the outgoing Dutch Youth Ambassador for SRHR Sanne Thijssen . “ One argument you make could resonate with one person and shift everything .” She sees three barriers to getting young people involved in SRHR: “People in positions of power are afraid to let go of the reigns; Meaningful youth engagement needs investment; The added value of engaging young people is overlooked.” She insists, “Stay passionate and keep reaching out to other young advocates. Young people can shape the present!”

Anti-choice groups in the US are using the individual tactic as well, reaching out to abortion clinic workers to try to convince them to quit. 
Access to Safe Abortion
CIRHT works with partner institutions on pre-service training for doctors, nurses and midwives in Comprehensive Abortion Care. A new study from IPAS also calls for post-training support as well, providing “ a key to high-quality care .”  

In the UK , abortion clinics will be given starred ratings by the Department of Health’s Care Quality Commission. British Columbia has become the sixth Canadian province to provide free access to the abortion pill .

Preserving access to safe and legal abortion remains a political battle in Chile , despite a recent change in the law. In Brazil , women are telling their stories of illegal and dangerous abortion to oppose proposed new restrictions. And Ireland is having an open debate about the upcoming referendum on repealing an anti-abortion constitutional article. A debate has also begun in heavily-Catholic Malta .  

Safe and effective use of the abortion pill has been shown in yet another study, leading the American College of Obstetricians and Gynecologists to object to the “criminalization” of self-induced abortions

Debates continue across the US, where the Trump administration is trying to deny abortion rights to undocumented teenagers , and in the courts and legislatures of New York , Illinois , Indiana , and Utah . As an indicator of regional disparities, Kentucky is poised to become the first US state without an abortion clinic , while Hawaii is piloting “tele-abortion” for people who lives miles (or islands) away from the nearest clinic; an Ohio clinic is boldly advertising on billboards yet in Wisconsin Catholic hospitals are gaining market share and therefore restricting access to abortions and even tubal ligations . The various barriers that are put in place can be explored through a browser-based video game called “ Trapped .” 
Research resources available
An in-depth research and clinical information resource on reproductive health is curated by Taubman Health Sciences Library at the University of Michigan. The materials are open access and include:

  • RSS feeds to keep current in the biomedical and health sciences literature
  • Research and clinical (point of care) databases
  • Selected open access journals
  • Freely available online health sciences books
  • Health and epidemiology data sources
  • Evidence-based medicine (EBM) guides and resources
  • Selected freely available health-related mobile resources
Policy Frameworks Are Needed
Many developing nations have rapidly increased their use of modern contraceptive strategies and have decreased their unmet needs for safe and effective contraceptives , according to a systematic analysis of the Family Planning Estimation Tool (FPET) published in  The   Lancet. Kenya was found to be one of the fastest progressing countries in this study in increasing Modern Contraception Prevalence Rate (mCPR) and decreasing unmet need, and this country may "provide case studies for achieving success in other countries.” UNESCO released a report calling for a “ comprehensive approach to sexuality education. ” As Global Health Now notes, “Yes, we are bending the curve toward our goal of reaching 120 million more family planning users by 2020, but we still have a long way to go . Despite the recent wins, we are not on track to meet this goal.”

Family Planning advocacy is “ the best way to fight maternal mortality ” in Nigeria, which is undertaking a new three-year plan for family health . Again, mixed messages coming from the Kenyan press: An NGO wants the rollout of sex education stopped , while a church leader has become a Family Planning champion

The abortion debate in Namibia reflects ambiguity about overturning Apartheid-era laws , throwing off colonial laws but still striving to represent the consensus in a deeply religious country.
Selected News Source References
Academic

Contraceptive Use over Five Years After Receipt Or Denial of Abortion Services , Perspectives on Sexual and Reproductive Health, 12 Jan 2018

Modern Contraceptive Use Increasing in Developing Nations , Endocrinology Advisor, 11 Jan 2018

Adolescents and Youth Dashboard , UNFPA, 5 Jan 2018 (Updated resource)

Policy Trends in the States, 2017 , Guttmacher, 2 Jan 2018




Algeria

Burkina Faso

Burundi

Cote d’Ivoire

DRC
This Congolese Girl for President , K4Health, 11 Jan 2018

Egypt

Gambia

Kenya




Ignore family planning urges Sudi , Hivisasa, 31 Dec 2017

Madagascar

Malawi
Effect of family planning interventions on couple years of protection in Malawi , International Journal of Gynecology & Obstetrics, 9 Jan 2018

Woman in custody for concealing birth , Malawi News Agency, 5 Jan 2018

Namibia
In Namibia's abortion debate, echoes of a repressive history , Christian Science Monitor, 11 Jan 2018

Nigeria

Checking the increasing rate of unsafe abortion , Nigerian Tribune, 18 Jan 2018
Stakeholders say global gag rule is anti-women , Nigerian Tribune, 18 Jan 2018






Rwanda

Senegal
In Senegal, family planning finds a key ally: imams , Christian Science Monitor, 4 Jan 2018

South Africa



Tanzania



Uganda

Zambia

Southern males in branded, flavoured protection , Times of Zambia, 19 Jan 2018


Zimbabwe

Global/General

L'autonomisation de la femme et de la révolution contraceptive. , Partenariat d’Ouagadougou, 24 Jan 2018


One year on and fighting for our futures  , She Decides, 24 Jan 2018


Empowerment in the Developing World , Center for Global Development, 24 Jan 2018




Looking Ahead for 2018 , Medium/FP2020, 18 Jan 2018




Dreaming of Female Condoms , FC2, 9 Jan 2018






EALA set to debate sexual health Bill , The East African, 3 Jan 2018

Is There A Human Right to Contraception? , Rights Info, 3 Jan 2018

Under Three Minutes , Elle UK, 3 Jan 2018

USA





Global Gag Rule , Repros Fight Back, 16 Jan 2018

Report on the State of Women’s Health Policy 2018 , Planned Parenthood Action Fund, January 2018






#MeToo: A Reckoning , ReproAction, 5 Jan 2018







Reproductive Health Professionals Changing Lives