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A Resolution for 2014: Eliminating Health Care Inequality

A Resolution for 2014: Eliminating Health Care Inequality

Posted: 01/17/2014 9:31 am

As we ease into 2014, many of us are continuing to make good on New Year's resolutions to better ourselves and appreciate the good in our lives in an increasingly unpredictable world.
I have the fortune to experience this hope and inspiration each time I walk through the doors of the International Planned Parenthood/Western Hemisphere Region offices. From lawyers to doctors to human rights advocates, my colleagues are remarkable. They work hard and long hours, often spending weeks away from their families to lend their expertise and passion to ensuring the most rural and marginalized communities in Latin America and the Caribbean -- one of the most unequal regions in the world -- have a voice and a choice.
Recently, I had the opportunity to chat with Jessie Clyde, our Youth Program Officer, about her work. Given the recent news about the decline of the Argentinian economy and the murder of Miss Venezuela, protecting the health and rights of the region's 106 million youth is one of the most crucial and impactful investments we can make. I hope you enjoy her guest post on how inequality impacts sexual and reproductive health:
Flip through a guide book on Latin America and you'll read about steak houses in Argentina, powdery white beaches in Mexico and eco-friendly resorts in the jungles of Costa Rica. Read the news and you'll learn about Brazil hosting the next World Cup, the growth of Mexico's middle class, and Venezuela's obsession with plastic surgery.
Compared to other regions of the world, Latin America seems to be doing well at first glance. Health indicators show progress: maternal and child mortality numbers have dropped, contraceptive use is up and abortion was even legalized in Mexico City in 2011. But as a public health professional in the region with a focus on the sexual and reproductive health of adolescents, I'm not so quick to celebrate these victories: My fieldwork has taught me that national averages often tell a very different story than the reality found on the ground.
All it takes is a quick detour from the urban capitals and glossy tourist havens to see the large number of people in the region who still desperately need quality health services. On a recent trip to Venezuela, it took only a few minutes to leave the sparkling city behind and find ourselves in the slums of the surrounding hills. On these steep streets, I encountered a pregnant 15 year-old girl who didn't have the information or access to services to prevent unintended pregnancies. A short boat ride away from the famous turquoise waters of the Belize cayes, young people speak to me about high levels of violence, HIV and adolescent pregnancies. And in Argentina, I have spoken with undocumented immigrants in public hospitals who struggle to get their basic health care needs met because of discrimination.
A recent study by the Guttmacher Institute backs up my observation that while the region as a whole is doing well, there are still pockets of extreme poverty that leave women unable to access basic services. The report begins by telling us the good news. Approximately seven out of 10 married Mexican women of childbearing age currently use a contraceptive method (a level similar to the United States), family size has declined from about six children in the 1970s to just over two, and maternal mortality has fallen significantly.
However, despite these impressive achievements, large disparities by population subgroups remain. The services, supplies and human resources that allow women in wealthier urban areas to plan their families are not always available to all. Poorer states such as Chiapas, Guerrero and Oaxaca still have large populations living in homes with no indoor plumbing or electricity, let alone access to sexual and reproductive health care. Not surprisingly, the indicators in those regions aren't quite as rosy. For example, abortions in Mexico City are safe and accordingly, just 0.5 percent of these procedures were associated with mild complications in 2009. However, of the abortions obtained by poor rural women, 45 percent led to complications. This figure is even more striking when you consider the fact thatnearly half of Mexico's population lives in poverty.
The first step in closing these gaps is to have the data that proves they exist. The Guttmacher study is a great step forward, but comparable data for other countries in the region is largely unavailable, leaving health professionals without the quantitative data needed to shift policies and budgets.
Latin America is a diverse region that spans the peaks of the Andes to the tributaries of the Amazon to the Panama Canal. That is a diversity that we should continue to celebrate. However, when it comes to access to health care and sexual and reproductive health indicators, we want to see fewer differences across those mountains, rivers and canals.

http://www.huffingtonpost.com/alexander-sanger/a-resolution-for-2014-eli_b_4614688.html

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Ken Edelin
Ken Edelin died last week at age 74. In addition to his distinguished career as a physician, Ken served as Chair of the Board of the Planned Parenthood Federation of America for three years, 1989-1992. I had the honor of sharing a podium with him in San Francisco when we were both honored by the local Planned Parenthood affiliate. He spoke passionately about his trials and tribulations serving women who had no other choices or access. He was an example for physicians everywhere in his dedication and willingness to put his patients first. Women have access to safer abortion procedures now because of his example and trial. I am glad to have know him.
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Women's Rights in 2013--- The Good, The Bad and the Ugly

Alexander Sanger

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The Good, the Bad and the Ugly: Women's Rights in 2013

Posted: 12/30/2013 1:36 pm

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As we reflect on the events of 2013, I can't help but think of the Clint Eastwood classic The Good, the Bad, and the Ugly.
When it came to women's rights, there was indeed ugliness: more and more states tried to restrict women's access to basic reproductive health care, and in El Salvador, Glenda Cruz was sentenced to 10 years in prison for miscarrying.
Despite these setbacks, there is reason for hope. Here's my wrap-up of the top five wins for sexual and reproductive rights in 2013:
1. The rape and murder of a 23 year-old woman in New Delhi set off widespread protests throughout India. In September, an Indian court sentenced the four perpetrators to death, stating that the crime "shocked the collective conscience of India."
"In these times when crimes against women are on the rise," said Judge Yogesh Khanna,"the court cannot turn a blind eye to this gruesome act." The significance of this statement condemning violence against women in the world's second most populous country cannot be understated at a time when one in three women worldwide will experience violence in their lifetimes.
2. In the Dominican Republic, the Catholic Church filed a legal complaint against our local partner Profamilia, claiming that its ad campaign on sexual rights violated the Constitution. In May, the Fifth Civil and Commercial Chamber of the National District rejected the Church's complaint as a violation of freedom of expression, adding that campaigns like Profamilia's help to promote comprehensive sexuality education and responsible parenthood. The public and media support for Profamilia during and after the case was massive, but it was not an easy battle.
3. As more states sought measures to tighten abortion laws, some fought to make it more accessible. In June, Texas senator Wendy Davis rose to national prominence during a 13-hour filibuster protesting SB5, a bill that would further restrict abortion access in Texas. While the legislation ultimately passed, a vigorous protest from Davis -- and supporters throughout the country -- was heard loud and clear. In California, Gov. Jerry Brown signed a measure into law that allows nurse practitioners, certified nurse-midwives and physicians' assistants who complete specified training to perform abortions.
4. On August 15, the first session of the Regional Conference on Population and Development concluded as representatives of 38 countries in Latin America and the Caribbean adopted an historic agreement: the Montevideo Consensus on Population and Development. At this meeting to assess progress towards implementing the Cairo Programme of Action, governments recognized the important connections between sexual and reproductive health and rights and the global development agenda. More than 250 members of civil society -- including IPPF/WHR and our Member Associations -- helped forge this victory. The Consensus is the first UN agreement to include a definition of sexual rights, "which embrace the right to a safe and full sex life, as well as the right to take free, informed, voluntary and responsible decisions on their sexuality, sexual orientation and gender identity, without coercion, discrimination or violence." With governments poised to adopt a new global development framework, this agreement will help ensure that sexual rights and reproductive rights remain at the center of efforts to reduce poverty and improve the well-being of individuals, communities and nations.
5. Perhaps the greatest "good" is the fact that despite fierce opposition, millions of women, men and young people throughout the world continue to fight to ensure that all people have access to quality healthcare and protection of their human rights. In 2012, we provided nearly 33 million services throughout the Americas and Caribbean with more than 75% of those services reaching poor and vulnerable populations. In a region where an estimated 95% of abortions take place in unsafe circumstances, the importance of access to contraception and accurate health information cannot be underestimated.

http://www.huffingtonpost.com/alexander-sanger/the-good-the-bad-and-the-ugly-womens-rights-in-2013_b_4519800.html
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Alexander Sanger
Alexander C. Sanger, the grandson of Margaret Sanger, who founded the birth control movement over eighty years ago, is currently Chair of the International Planned Parenthood Council.
Mr. Sanger previously served as the President of Planned Parenthood of New York City (PPNYC) and its international arm, The Margaret Sanger Center International (MSCI) for ten years from 1991 - 2000.

Mr. Sanger speaks around the country and the world and has served as a Goodwill Ambassador for the United Nations Population Fund.

Beyond Choice
Beyond Choice
The new book by Alexander Sanger published by PublicAffairs


Purchase from Amazon.com

Click here for full book information

With reproductive freedom in jeopardy, Alexander Sanger, grandson of renowned family planning advocate Margaret Sanger and a longtime leader in the reproductive rights movement, has taken an urgent, fresh look at the pro-choice position—and even the pro-life position—and finds them necessary, but insufficient. In Beyond Choice he offers the first major re-thinking of these positions in thirty years.

“Well researched and readable, Beyond Choice should be required reading for both pro-choice and pro-life supporters.”
—Governor Christine Todd Whitman

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» Much more on Beyond Choice, including an excerpt, discussion guides, reviews
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Jamie Smith, The Daily Vidette

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