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

The Lancet (British edition), 2017-11, Vol.390 (10110), p.2372-2381 [Tạp chí có phản biện]

2017 World Health Organization ;Copyright © 2017 World Health Organization; licensee Elsevier. This is an Open Access article published under the CC BY-NC-ND 3.0 IGO license which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is properly cited. This article shall not be used or reproduced in association with the promotion of commercial products, services or any entity. There should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL. ;Copyright Elsevier Limited Nov 25, 2017 ;2017. World Health Organization. Copyright © 2017 World Health Organization; licensee Elsevier. This is an Open Access article published under the CC BY-NC-ND 3.0 IGO license which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is properly cited. This article shall not be used or reproduced in association with the promotion of commercial products, services or any entity. There should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL. ;2017 World Health Organization 2017 ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(17)31794-4 ;PMID: 28964589

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Nhan đề:
Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model
Tác giả: Ganatra, Bela ; Gerdts, Caitlin ; Rossier, Clémentine ; Johnson, Brooke Ronald ; Tunçalp, Özge ; Assifi, Anisa ; Sedgh, Gilda ; Singh, Susheela ; Bankole, Akinrinola ; Popinchalk, Anna ; Bearak, Jonathan ; Kang, Zhenning ; Alkema, Leontine
Chủ đề: Abortion ; Abortion, Induced - statistics & numerical data ; Abortion, Legal - statistics & numerical data ; Abortion, Therapeutic - statistics & numerical data ; Bayes Theorem ; Bayesian analysis ; Classification ; Cohort Studies ; Databases, Factual ; Developed countries ; Developed Countries - statistics & numerical data ; Developing countries ; Developing Countries - statistics & numerical data ; Estimates ; Female ; Global Health ; Humans ; Internationality ; Language ; Laws ; LDCs ; Low income groups ; Misoprostol ; Mortality ; Patient Safety ; Pregnancy ; Prevalence ; Primary care ; Risk Assessment ; Safety ; Socioeconomic factors ; United Nations ; Womens health
Là 1 phần của: The Lancet (British edition), 2017-11, Vol.390 (10110), p.2372-2381
Mô tả: 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. 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. We used a three-tiered categorisation based on the WHO definition of unsafe abortion and WHO guidelines on safe abortion to categorise abortions as safe or unsafe and to further divide unsafe abortions into two categories of less safe and least safe. Of the 55· 7 million abortions that occurred worldwide each year between 2010–14, we estimated that 30·6 million (54·9%, 90% uncertainty interval 49·9–59·4) were safe, 17·1 million (30·7%, 25·5–35·6) were less safe, and 8·0 million (14·4%, 11·5–18·1) were least safe. Thus, 25·1 million (45·1%, 40·6–50·1) abortions each year between 2010 and 2014 were unsafe, with 24·3 million (97%) of these in developing countries. The proportion of unsafe abortions was significantly higher in developing countries than developed countries (49·5% vs 12·5%). When grouped by the legal status of abortion, the proportion of unsafe abortions was significantly higher in countries with highly restrictive abortion laws than in those with less restrictive laws. Increased efforts are needed, especially in developing countries, to ensure access to safe abortion. The paucity of empirical data is a limitation of these findings. Improved in-country data for health services and innovative research to address these gaps are needed to improve future estimates. UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction; David and Lucile Packard Foundation; UK Aid from the UK Government; Dutch Ministry of Foreign Affairs; Norwegian Agency for Development Cooperation.
Nơi xuất bản: England: Elsevier Ltd
Ngôn ngữ: English
Số nhận dạng: ISSN: 0140-6736
EISSN: 1474-547X
DOI: 10.1016/S0140-6736(17)31794-4
PMID: 28964589
Nguồn: ProQuest One Psychology
MEDLINE
ProQuest Central

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

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