Reproductive Health

Partner reduction is crucial for balanced “ABC” approach to HIV prevention

James D Shelton
Daniel T Halperin
Vinand Nantulya
Malcolm Potts
Helene D Gayle
King K Holmes

Behaviour change programmes to prevent HIV have mainly promoted condom use or abstinence, while partner reduction remains the neglected component of ABC

The key to preventing the spread of HIV, especially in epidemics driven mainly by heterosexual transmission, is through changing sexual behaviour. Interest has been growing in an “ABC” approach in which A stands for abstinence or delay of sexual activity, B for be faithful, and C for condom use. Although “be faithful” literally implies monogamy, it also includes reductions incasual sex and multiple sexual partnerships (and related...

Why Can’t a Man Be More Like a Woman? Sex, Power, and Politics

Malcolm Potts

Conflicts between male and female reproductive agendas continue to play out in contemporary issues of sex, power, and politics. Viewing gender through the lens of biologic evolutionary psychology reveals persistent con- troversies surrounding women’s rights. The history of oral contraceptives com- pared with that of erectile dysfunction drugs is just one example of the disparity between female and male reproductive choices. Contraceptives, maternal mortality, abortion, and domestic violence are issues directly influenced by politics, religion, and gender biases. Ultimately, everything that...

Kenya: Reaching the Poor through the Private Sector-A Network Model for Expanding Access to Reproductive Health Services

N Prata
D Montagu
M Campbell
J Walsh
S Orero

Health services can make an important contribution to improved health conditions among disadvantaged groups. Yet, the services supported by governments and development agencies too often fail to reach these people who need them most. Reaching the Poor with Health, Nutrition, and Population Services marshals the available evidence about pro-poor strategies that have proven to be effective and that can help in the development of programs to better assist disadvantaged groups. In doing so, it can serve as a resource for policy makers, development practitioners, and policy analysts concerned...

Parachute approach to evidence based medicine

M Potts
N Prata
J Walsh
A Grossman

Waiting for the results of randomised trials of public health interventions can cost hundreds of lives, especially in poor countries with great need and potential to benefit. If the science is good, we should act before the trials are done. Good science, we suggest, is taking the research to the problem rather than conducting the research in the tallest ivory tower the investigator can find. Randomised controlled trials are needed and, when appropriate, should be part of the empirical evidence necessary for decision making. The question is how much evidence is needed to move from research...

Abortion perspectives

Malcolm Potts

A look at abortion from the perspective of a doctor who has performed abortions, a physician who also has a PhD in embryology, and someone who had the privilege of working all over the world in various aspects of human reproduction and sexuality.

Published in The European Journal of Contraception and Reproductive Health Care, June 2010;15:157–159

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A Woman Cannot Die from a Pregnancy She Does Not Have

Malcolm Potts
Nadia Diamond-Smith

The fifth Millennium Development Goal has brought critical attention to the unacceptably high burden of maternal mortality and the need to improve antenatal health care. However, many of the approaches to reducing maternal mortality (e.g., increasing the number of deliveries at health facilities with skilled attendants or improving access to emergency obstetric care) are complex and will take time to implement. In the meantime, maternal mortality can be reduced relatively inexpensively by preventing unwanted pregnancy through family planning. The decision to practice family planning is...

If, when and how to tell: a qualitative study of HIV disclosure among young women in Zimbabwe

Sophia Zamudio-Haas
Imelda Mudekunye-Mahaka
Barrot H. Lambdin
Barrot H. Lambdin

In the Shona culture of Zimbabwe, a high regard for childbearing contributes to strong pressures on women to have children. For young women living with HIV, consequently, disclosure of HIV status can be a central strategy to garner support for controlling fertility. This paper reports findings from qualitative interviews with 28 young women aged 16–20 living with HIV in urban Zimbabwe and discusses how these findings can contribute to better policies and programs for this population. Regardless of their current relationship status, interview participants described disclosure as a turning...

The remarkable story of Romanian women’s struggle to manage their fertility

Mihai Horga
Caitlin Gerdts
Malcolm Potts

In 1957, along with many countries in Eastern Europe, Romania liberalised its abortion law. The Soviet model of birth control made surgical abortion easily available, but put restrictions on access to modern contraceptives, leading to an exceptionally high abortion rate. By the mid-1960s there were 1 100 000 abortions performed each year in Romania, a lifetime average of 3.9 per woman, the highest number ever recorded. In October 1966, 1 year after coming to power, in an attempt to boost fertility, Romania’s communist leader Nicolae Ceausescu made abortion broadly illegal, permitting the...

Global warming and reproductive health

Malcolm Potts
Courtney E. Henderson

The largest absolute numbers of maternal deaths occur among the 40–50 million women who deliver annually without a skilled birth attendant. Most of these deaths occur in countries with a total fertility rate of greater than 4. The combination of global warming and rapid population growth in the Sahel and parts of the Middle East poses a serious threat to reproductive health and to food security. Poverty, lack of resources, and rapid population growth make it unlikely that most women in these countries will have access to skilled birth attendants or emergency obstetric care in the...

Misoprostol Regimens Pocket Reference for Clinicians: Rwanda


A pocket reference for clinicians, this Misoprostol Regimens Pocket Guide from Rwanda details the dosage and route recommendations for the administraiton of misoprostol use in obstetrics and gynecology.

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