DOCSLIB.ORG

University of Southampton Research Repository Eprints Soton

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
University of Southampton Research Repository Eprints Soton University of Southampton Research Repository ePrints Soton Copyright © and Moral Rights for this thesis are retained by the author and/or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This thesis cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder/s. The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders. When referring to this work, full bibliographic details including the author, title, awarding institution and date of the thesis must be given e.g. AUTHOR (year of submission) "Full thesis title", University of Southampton, name of the University School or Department, PhD Thesis, pagination http://eprints.soton.ac.uk UNIVERSITY OF SOUTHAMPTON Faculty of Social and Human Sciences School of Social Sciences NATURAL CONTRACEPTIVE USE IN A MODERN POPULATION: CORRELATES, FERTILITY TIMING AND EFFICACY AMONG USERS IN MOLDOVA Mark James Lyons-Amos Thesis for the degree of Doctor of Philosophy April 2012 i Abstract This thesis investigates the dynamics of natural contraceptive method use in a low fertility setting in contemporary Eastern Europe. Natural contraception was one of the key drivers of European fertility transition and still accounts for a large proportion of current method use in the developing world as well as in the Eastern Europe. Nonetheless, little systematic research on natural method use exists in contemporary demographic literature. This thesis focuses on the post-Socialist republic of Moldova- the poorest country in Europe. The Moldovan contraceptive regime, as observed elsewhere in Eastern Europe, is characterised by limited uptake of modern contraception and widespread use of induced abortion. Under the Moldovan Socialist government, social pressures including the requirement of children to obtain housing led to an almost homogenous pattern of early low fertility. In examining natural method use in the Moldova, this thesis addresses not only the limited understanding of natural method use in contemporary societies, but also contributes to unravelling the potential interaction between contraception and abortion in a low fertility setting. The main aims of this thesis are to: (i) provide a quantitative evaluation of the dynamics of natural contraceptive use in a low fertility setting and (ii) explore the changing fertility situation in Moldova. These aims are accomplished using data from the first ever Demographic and Health Survey (DHS) conducted in Moldova during 2005. The thesis comprises four research chapters as well as an introduction and conclusion. The introduction chapter examines the significance of natural methods in historical and contemporary societies, and provides context on the Moldovan demographic and socio-economic context. The second chapter examines the factors influencing the use of natural contraceptive methods. Specifically, the effect of economic hardship on the persistence of natural contraceptive use is examined. The analysis also evaluates the impact of FP programmes designed to reduce reliance on natural methods at a regional level. It contributes direct policy relevance by improving understanding of the efficacy of reproductive health interventions. In particular, the ii chapter identifies an impact of uneven coverage of health infrastructure on contraceptive choice and switching patterns. The second and third chapters evaluate the fertility timing patterns associated with natural method use – specifically the effect of contraceptive confidence on the interval between marriage and first birth and all subsequent birth intervals. These analyses also expand the understanding of contraceptive confidence by examining the interaction between natural method use and induced abortion. The fourth chapter tests the hypothesis that natural method use is in fact less effective than modern method use. This is pertinent to the peculiar demographic situation in Moldova, where low fertility occurs concurrently with a high prevalence of natural method use. The analysis evaluates the determinants of contraceptive discontinuation using the contraceptive histories recorded in the DHS contraceptive calendar. Key results are the high failure rates of natural contraceptives, and the high propensity of modern reversible method users to abandon use- hence exposing them to unwanted pregnancy. The final chapter summarises the key findings from each paper and addresses the policy implications as well as limitations of the thesis. Areas for future research are also identified. iii Table of contents Chapter 1: Introduction …………... 1 1.1 Motivation and research problem …………... 1 1.2 Research objectives …………... 2 1.3 Research questions …………... 3 1.4 Natural contraception in historical and contemporary societies …………... 4 1.5 The Moldovan demographic and socioeconomic context …………... 6 1.6 Policy relevance …………... 11 1.7 Structure of the thesis …………... 12 …………... 14 Chapter 2: The correlates of natural method use in Moldova 2.1 Aims and introduction …………... 15 2.2 Conceptual framework and research hypotheses …………... 19 2.2.1 The effect of economic disadvantage …………... 20 2.2.2 The effect of Moldovan FP programmes – NPRH and NPAIDS …………... 22 2.2.3 Confounding factors: demographic effects and the desire and ability to have children …………... 24 2.2.4 Contraceptive network effects …………... 26 2.3 Analysis sample …………... 27 2.4 Variable operationalization …………... 30 2.4.1 Response variable …………... 30 2.4.2 Measurement of market cost barriers …………... 31 2.4.3 Measurement of FP impact; variables measuring the effect of NPRH and NPAIDS …………... 36 2.4.4 Confounding factors …………... 37 2.4.5 Data limitations …………... 40 2.5 Methodology …………... 43 2.5.1 Regression model …………... 43 2.5.2 Modelling strategy …………... 44 2.6 Results and interpretation …………... 46 2.6.1 Descriptive results …………... 46 2.6.2 Results from regression modelling …………... 51 2.7 Conclusion, evaluation and policy recommendations …………... 75 iv Chapter 3: Contraceptive confidence and the timing of first birth in transitional Moldova …………… 79 3.1 Introduction and motivation …………... 80 3.2 Theoretical motivation and research hypotheses …………... 81 3.2.1 The effect of contraceptive confidence on birth timings …………... 82 3.2.2 The role of induced abortion in Moldovan fertility control regime …………... 82 3.2.3 Temporal effects: crisis and adjustment …………... 84 3.3 Data …………... 86 3.3.1 Moldovan Demographic and Health Survey …………... 86 3.3.2 Analysis sample …………... 87 3.4 Definition of explanatory variables …………... 88 3.4.1 Contraceptive confidence: Current contraceptive method …………... 88 3.4.2 Propensity to use induced abortion …………... 89 3.4.3 Temporal effects …………... 90 3.4.4 Control variables …………... 92 3.5 Methodology …………... 93 3.5.1 Piecewise constant hazard model …………... 93 3.5.2 Modelling strategy …………... 95 3.6 Results …………... 96 3.6.1 Descriptive analysis …………... 96 3.6.2 Regression modelling results …………... 104 3.7 Summary and conclusions …………... 124 Chapter 4: The effect of contraceptive confidence on inter-birth intervals in a setting with high levels of induced abortion ………………. 129 4.1: Introduction ………………. 130 4.2: Theoretical motivation and research hypotheses …………... 131 4.2.1 he effect of contraceptive confidence on birth timings …………... 131 4.2.2 The role of induced abortion in the Moldovan fertility control regime …………... 136 4.3 Data …………... 138 4.4 Explanatory variables …………... 141 4.4.1 Current contraceptive method …………... 141 4.4.2 Abortion ratio …………... 142 4.4.3 Control variables …………... 143 4.5 Methodology …………... 145 4.5.1 Regression model …………... 145 4.5.2 Model selection strategy …………... 147 4.6 Results …………... 148 4.6.1 …………... 148 v 4.6.2 Regression analysis …………... 156 4.7 Summary and discussion …………... 178 Chapter 5: Evaluating natural contraceptive failure and contraceptive discontinuation in Moldova …………... 181 5.1 Introduction …………... 182 5.2 Background and Research hypotheses …………... 183 5.2.1 Effectiveness of natural method use: an historical review …………... 185 5.2.2 Evidence for ineffective modern method use …………... 187 5.3 Data …………... 190 5.3.1 Contraceptive calendar data in the MDHS …………... 190 5.3.2 Analysis sample …………... 194 5.4 Explanatory variables …………... 195 5.4.1 Contraceptive type …………... 195 5.4.2 Controls for proximate determinants of fertility …………... 196 5.4.3 Socio-economic controls …………... 198 5.5 Methodology …………... 202 5.5.1 Regression model …………... 202 5.5.2 Modelling strategy …………... 204 5.6 Results …………... 206 5.6.1 Descriptive analysis …………... 206 5.6.2 Regression model …………... 211 5.6 Conclusions …………... 223 …………... Chapter 6: Conclusions …………... 226 6.1 Summary and research questions …………... 226 6.2 Further research …………... 229 6.3 Policy implications …………... 230 …………... References …………... 233 Appendix A: Correlation matrix and scoring factors for PCA of asset ownership …………... 241 Appendix B: Correlation matrix and scoring factors for PCA of FP media exposure …………... 242 Appendix C: Estimated hazard plots by previous method discontinued given a) modern reversible method use (moderate contraceptive confidence, b) non-use (unobserved), c) natural method use (low) and d) permanent method use (high) …………... 243 vi Appendix D: Estimated survival curves by previous method discontinued given a) modern reversible method use (moderate contraceptive confidence, b) non-use
Load more

Recommended publications
  • MEDICATION ABORTION Overview of Research & Policy in the United States
    MEDICATION ABORTION Overview of Research & Policy in the United States Liz Borkowski, MPH Julia Strasser, MPH Amy Allina, BA Susan Wood, PhD Bridging the Divide: A Project of the Jacobs Institute of Women’s Health December 2015 CONTENTS INTRODUCTION ................................................................................................................... 2 OVERVIEW OF MEDICATION ABORTION ...................................................................... 2 MECHANISM OF ACTION .............................................................................................................................. 2 SAFETY AND EFFICACY ................................................................................................................................. 4 FDA DRUG APPROVAL PROCESS ....................................................................................... 6 FDA APPROVAL OF MIFEPREX ................................................................................................................... 6 GAO REVIEW OF FDA APPROVAL PROCESS FOR MIFEPREX ................................................................ 8 MEDICATION ABORTION PROCESS: STATE OF THE EVIDENCE ............................ 9 FDA-APPROVED LABEL ............................................................................................................................... 9 EVIDENCE-BASED PROTOCOLS FOR MEDICATION ABORTION ........................................................... 10 Dosage .......................................................................................................................................................
    [Show full text]
  • Self-Assessment of the Outcome of First Trimester Medical Abortion Compared to Routine Clinic Follow-Up: a Systematic Review
    Faculty of Health Science. Department of Community Medicine Self-assessment of the outcome of first trimester medical abortion compared to routine clinic follow-up: A systematic review Nikita Baiju Master’s Thesis in Public Health, HEL-3950 Supervisor: Professor Rigmor C. Berg. Department of Community Medicine. UiT-The Arctic University of Norway Co-Supervisor: Professor Dr. Ganesh Acharya. Women's Health and Perinatology Research Group. Department of Clinical Medicine. UiT-The Arctic University of Norway May 15, 2017 ACKNOWLEDGEMENT The entire process of this research project, starting from topic selection to the point of writing the report, was not an easy task. It would not have been possible without the help and support of numerous individuals, professors, friends, and family. I am privileged to have the opportunity to work on this dissertation. Therefore, I would like to express my sincere gratitude to the Department of Community Medicine, UiT-The Arctic University of Norway, for entrusting me with this project. I would like to express my sincere thanks and indebtedness to my supervisor, Professor Rigmor C. Berg, for her expert guidance and constant supervision, ever-abiding encouragement and timely help. Her tactful suggestions and her belief in me that this review is completely doable within this short time period have encouraged me to complete this review successfully. I would also like to thank my co-supervisor, Professor Dr. Ganesh Acharya, for his guidance and unconditional support in this thesis work. I cannot thank enough the search experts Eirik Reierth and Grete Overvåg from UiT-The Arctic University of Norway and Lien Nguyen from National Institute of Public Health for their expert advice and indispensable help in developing the search strategy for this systematic review.
    [Show full text]
  • Integrating Self-Managed Medication Abortion with Medical Care: a Briefing Paper
    INTEGRATING SELF-MANAGED MEDICATION ABORTION WITH MEDICAL CARE: A BRIEFING PAPER April 26, 2021 EXECUTIVE SUMMARY This briefing document about self managed medication abortion (SMMA) offers a framework that emphasizes context and integration of SMMA with medical care. It was written in 2020 by Global Doctors for Choice, an international network of physicians who advocate for reproductive health care and rights. Its primary goal is to provide physicians and other healthcare providers with a synthesis of evidence from around the world to inform their clinical practice and their advocacy. The advent of medication abortion has enabled some women to end their pregnancies with little or no clinician involvement. There are a range of perspectives on self-managed medication abortion. Some emphasize the liberatory advances for women’s autonomy, others are concerned about possible adverse health consequences. Since Global Doctors for Choice supports doctors working in different contexts around the world, this document highlights clinical concerns and advocacy opportunities for clinicians in both low- and high-resource settings, and in places with varying legal and administrative restrictions on abortion. Several recent global developments are salient. During to the Covid-19 pandemic, access to abortion care has been compromised, pushing health systems to adopt more self-managed care options. Over the past several years, medical standard setting bodies have endorsed “patient centered care,” which is respectful and responsive to patient preferences, needs and values, and supports patient participation in their own care, be it diabetes, asthma, or labor and delivery. Concurrently, distrust and dismissal of science and scientists has surged across a wide range of issues, from climate change, to vaccines, to wearing masks during the Covid-19 pandemic.
    [Show full text]
  • Strengthening Medical Abortion in South Africa
    Strengthening medical abortion in South Africa By Deborah Constant CNSDEB001 B.Sc (Phys), B.Sc Hons (Anat), M.Sc (Anat), MPH Thesis presented for the degree of Doctor of Philosophy in the School of Public Health and Family Medicine Faculty of Health Sciences UNIVERSITY OF CAPE TOWN August 2016 University of Cape Town Main Supervisor: Co-supervisor: Associate Professor Jane Harries Professor Landon Myer School of Public Health and Family Medicine School of Public Health and Family Medicine University of Cape Town University of Cape Town i The copyright of this thesis vests in the author. No quotation from it or information derived from it is to be published without full acknowledgement of the source. The thesis is to be used for private study or non- commercial research purposes only. Published by the University of Cape Town (UCT) in terms of the non-exclusive license granted to UCT by the author. University of Cape Town DECLARATION I, Deborah Constant, hereby declare that the work on which this thesis is based is original research and that neither the whole work nor any part of it has been, is being, or is to be submitted for another degree in this or any other university. The contents of this thesis are entirely the work of the candidate, or, in the case of multi- authored published papers and manuscripts prepared for publication, constitutes work for which the candidate was the lead author. The contribution of the candidate to multi- authored works is outlined in the preface to the thesis and in the introduction to each included paper and manuscript.
    [Show full text]
  • Simplified Medical Abortion Screening: a Demonstration Project☆,☆☆,★ ⁎ Elizabeth G
    Contraception xx (2017) xxx–xxx Original research article Simplified medical abortion screening: a demonstration project☆,☆☆,★ ⁎ Elizabeth G. Raymonda, , Yi-Ling Tana, Rodica Comendantb, Irina Sagaidacb, Stelian Hodorogeab, Melissa Grantc, Patricio Sanhuezad, Emigdio Van Prattd, Ginger Gillespiee, Christy Boraasf, Mark A. Weaverg, Ingrida Plataisa, Manuel Bousiegueza, Beverly Winikoffa aGynuity Health Projects, New York, NY 10010, USA bReproductive Health Training Center, Moldova cCarafem, Chevy Chase, MD dSecretariat of Health, Mexico City eInstitute for Family Health, New York fPlanned Parenthood Minnesota, North Dakota, South Dakota, Minneapolis, MN gUniversity of North Carolina at Chapel Hill, NC Received 16 August 2017; revised 6 November 2017; accepted 11 November 2017 Abstract Objectives: The objectives were to evaluate the safety and acceptability of outpatient medical abortion in selected women without a pretreatment ultrasound or pelvic examination. Study design: We conducted a prospective case-series study to estimate the incidence of serious adverse events (death, life-threatening event, hospitalization, transfusion or any other medical problem that we judged to be significant), surgical completion of the abortion and satisfaction in women provided with medical abortion without a pretreatment ultrasound or pelvic examination. We enrolled 406 women requesting medical abortion in Moldova, Mexico and the United States. To be eligible, a woman must have been certain that her last menstrual period started within the prior 56 days, have had regular menses before the pregnancy, not have used hormonal contraceptives in the prior 2 months (in the United States and Mexico) or 3 months (in Moldova), have no risk factors for or symptoms of ectopic pregnancy, and not have had an ultrasound or pelvic exam in this pregnancy.
    [Show full text]
  • Randomized Trial Assessing Home Use of Two Pregnancy Tests For
    CORE Metadata, citation and similar papers at core.ac.uk Provided by Elsevier - Publisher Connector Contraception 94 (2016) 115–121 Original research article Randomized trial assessing home use of two pregnancy tests for determining early medical abortion outcomes at 3, 7 and 14 days after mifepristone☆ ⁎ Jennifer Bluma, , Wendy R. Sheldona, Nguyen Thi Nhu Ngocb, Beverly Winikoffa, Nguyen Thi Bach Ngac, Roxanne Martina, Le Van Thanhd, Paul D. Blumenthala aGynuity Health Projects, New York, NY bCenter for Research Consultancy in Reproductive Health, Ho Chi Minh City, Vietnam cHung Vuong Hospital, Ho Chi Minh City, Vietnam dHocMon General District Hospital, Ho Chi Minh City, Vietnam Received 20 October 2015; revised 1 April 2016; accepted 4 April 2016 Abstract Objective: To evaluate the accuracy, feasibility and acceptability of two urine pregnancy tests in assessing abortion outcomes at three time points after mifepristone administration. Study design: This randomized trial enrolled women seeking early medical abortion at two hospitals in Vietnam. Investigators randomly allocated participants to at-home administration of a multilevel urine pregnancy test (MLPT) or a high sensitivity urine pregnancy test (HSPT) to assess their abortion outcomes. A baseline test was administered on the same day as mifepristone. Participants performed and interpreted results of pregnancy tests taken 3, 7 and 14 days after mifepristone. Ultrasound exam determined continuing pregnancy. Results: Six hundred women enrolled, and 300 received each test. A percentage of 97.4 (584) had follow-up, of whom 13 women had continuing pregnancies. The specificity of MLPT at detecting absence of continuing pregnancy was 63.9%, 90.4% and 97.1% at study day 3, 7 and 14.
    [Show full text]
  • A Compilation of the Work of the European Human Rights System
    THE APPLICATION OF HUMAN RIGHTS TO REPRODUCTIVE AND SEXUAL HEALTH: A COMPILATION OF THE WORK OF THE EUROPEAN HUMAN RIGHTS SYSTEM MARCH 2002 Information Compiled by: Julie Stanchieri, BA, LLB Isfahan Merali, BA, LLB Nell Rasmussen, LLM Dina Bogecho, BA Rebecca J. Cook, MPA, JD, JSD In co-operation with: Federation for Women and Family International Programme of Reproductive Planning, Poland and Sexual Health Law Nowolipie 13/15, 00-150 Faculty of Law, Warsaw, Poland; and University of Toronto, Toronto, Canada ASTRA - Central and Eastern European Women’s Network for Sexual and The Danish Centre for Human Rights Reproductive Health and Rights 38, Studiestraede Nowolipie 13/15, 00-150 DK-1455 Copenhagen K Warsaw, Poland; and Denmark SUMMARY TABLE OF CONTENTS INTRODUCTION..........................................................................................................................1 PART I – THE CONVENTION FOR THE PROTECTION OF HUMAN RIGHTS AND FUNDAMENTAL FREEDOMS .......................................................................................36 A) Introduction to the European Convention .......................................................................37 B) Basic Texts ...........................................................................................................................42 C) Application Form for the European Court ......................................................................66 D) Case-Law Under the European Convention ....................................................................75
    [Show full text]
  • Hcg Testing to Determine Outcome After Medical Abortion: a Review
    ncy gna and re C P h f Fiala et al., J Preg Child Health 2019, 6:2 il o d l H a e n DOI: 10.4172/2376-127X.1000409 a r l u t h o J Journal of Pregnancy and Child Health ISSN: 2376-127X ReviewResearch Article Article OpenOpen Access Access hCG Testing to Determine Outcome after Medical Abortion: A Review Christian Fiala1,7*, Teresa Bombas2, Mirella Parachini3, Aubert Agostini4, Roberto Lertxundi5, Marek Lubusky6 and Kristina Gemzell-Danielsson7 1Gynmed Clinic, Austria 2Obstetric Unit A, Coimbra University Hospital Center, Portugal 3San Filippo Neri Hospital, Italy 4Department of Obstetrics and Gynecology, La Conception hospital, France 5Clinica Euskalduna, Spain 6Department of Obstetrics and Gynaecology, Palacky University Hospital, Czech Republic 7Department of Women’s and Children’s Health, Karolinska Institute and Karolinska University Hospital, Sweden Abstract Introduction: The challenge in medical abortion is to reliably determine success of treatment within a short time interval, with the aim of improving evaluation of medical abortion outcomes. This can be done clinically using ultrasound (US) and/or hCG testing (urine human chorionic gonadotropin). The systematic use of US may lead to unnecessary surgical intervention and may be a barrier to the use of medical abortion when US is not accessible. Furthermore, US cannot be used in case of very early medical abortion with no confirmed intrauterine pregnancy at initiation of treatment. Serum hCG is highly reliable to judge on-going pregnancy and levels detected in urine correlate with serum levels. Self-assessment of the urine hCG test has proven to be effective and highly acceptable to women.
    [Show full text]
  • Simplifying Reproductive Health in Low-Resource Settings
    Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1163 Simplifying Reproductive Health in Low-Resource Settings Access to medical abortion and contraceptive choice, the importance of gendered structures in Rajasthan MANDIRA PAUL ACTA UNIVERSITATIS UPSALIENSIS ISSN 1651-6206 ISBN 978-91-554-9414-8 UPPSALA urn:nbn:se:uu:diva-267167 2015 Dissertation presented at Uppsala University to be publicly examined in Gustavianum, Akademigatan 3, Uppsala, Monday, 11 January 2016 at 13:00 for the degree of Doctor of Philosophy (Faculty of Medicine). The examination will be conducted in English. Faculty examiner: Professor Johanne Sundby (University of Oslo). Abstract Paul, M. 2015. Simplifying Reproductive Health in Low-Resource Settings. Access to medical abortion and contraceptive choice, the importance of gendered structures in Rajasthan. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1163. 144 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-554-9414-8. India introduced family planning in the ‘50s, legalized abortion in the ‘70s, and accomplished a remarkable drop in maternal mortality and fertility since 1990. Nevertheless, abortions account for a large proportion of maternal deaths, and sterilization is the most frequently used contraception. This thesis aims to identify the means to simplify and increase access to reproductive health in low-resource settings, focusing on abortion and contraception in Rajasthan. A randomized controlled trial compared simplified follow-up, where women assess their abortion outcome at home after early medical abortion, with in-clinic follow-up. Additionally, contraceptive use was compared between study groups post-abortion. In order to explore young women’s opportunities to access reproductive health services in the area, we conducted in-depth interviews with recently-married women.
    [Show full text]
  • Unsafe Abortion
    Unsafe abortion Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2000 Fourth edition World Health Organization Geneva, 2004 WHO Library Cataloguing-in-Publication Data World Health Organization. Unsafe abortion: global and regional estimates of incidence of unsafe abortion and associated mortality in 2000. -- 4th ed. 1.Abortion, Induced - epidemiology 2.Abortion, Induced - mortality 3.Review literature I.Title. ISBN 92 4 159180 3 (NLM classification: WQ 440) © World Health Organization, 2004 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: [email protected]). Requests for permission to reproduce or translate WHO publications—whether for sale or for noncommercial distribution— should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: [email protected]). The methodology of estimation has been reviewed and cleared for publication by Claudia Stein of the Evidence and Information for Policy (EIP) Cluster. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.
    [Show full text]
  • World Population Monitoring 2002
    ST/ESA/SER.A/215 Department of Economic and Social Affairs Population Division WORLD POPULATION MONITORING 2002 REPRODUCTIVE RIGHTS AND REPRODUCTIVE HEALTH United Nations New York, 2004 The Department of Economic and Social Affairs of the United Nations Secretariat is a vital interface between global policies in the economic, social and environmental spheres and national action. The Department works in three main interlinked areas: (i) it compiles, generates and analyses a wide range of economic, social and environmental data and information on which States Members of the United Nations draw to review common problems and to take stock of policy options; (ii) it facilitates the negotiations of Member States in many intergovernmental bodies on joint courses of action to address ongoing or emerging global challenges; and (iii) it advises interested Governments on the ways and means of translating policy frameworks developed in United Nations conferences and summits into programmes at the country level and, through technical assistance, helps build national capacities. NOTE The designations employed and the presentation of the material in this publication do not imply the expression of any opinion on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The designations of “more developed regions” and “less developed regions” are intended for statistical convenience and do not necessarily express a judgment about the stage reached by a particular country or area in the development process. The term “country” as used in the text of this publication also refers, as appropriate, to territories or areas.
    [Show full text]
  • 1 Secretary, Committee on Economic, Social and Cultural Rights UNOG
    April 14, 2011 Secretary, Committee on Economic, Social and Cultural Rights UNOG-OHCHR 1211 Geneva Switzerland The Committee on Economic, Social and Cultural Rights Re: Supplementary Information on Moldova, Scheduled for Review by the Committee on Economic, Social and Cultural Rights during its 46th Session Dear Committee Members: This letter is intended to supplement the periodic report submitted by the government of Moldova, which is scheduled to be reviewed during the 46th session of the Committee on Economic, Social and Cultural Rights (“the Committee”). The Institutul pentru Drepturile Omului din Moldova, based in Chişinǎu, Moldova and The Center for Reproductive Rights, based in New York are non-governmental organizations that hope to further the work of the Committee by providing independent information concerning the rights protected in the International Covenant on Economic, Social and Cultural Rights (hereinafter “ICESCR”). Reproductive rights are fundamental to women‟s health and social equality, and an explicit part of the Committee‟s mandate under the ICESCR. The commitment of states parties to uphold and ensure these rights deserves serious attention. We hope that the Committee‟s review will cover several areas of concern related to the status of the reproductive health and rights of women and adolescents in the Republic of Moldova. This letter is intended to provide a summary of the issues of greatest concern, as well as a list of questions that we hope the Committee will raise with the official delegation from the Republic of Moldova. The Right to Reproductive Health Services (Articles 2(2), 3, 10(2), and 12(1) of the ICESCR) Reproductive health and rights receive broad protection under the ICESCR.
    [Show full text]