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Record W2095539600 · doi:10.1016/s0968-8080(12)40652-8

Misoprostol and the politics of abortion in Sri Lanka

2012· article· en· W2095539600 on OpenAlexaff
Ramya Kumar

Bibliographic record

VenueReproductive Health Matters · 2012
Typearticle
Languageen
FieldMedicine
TopicReproductive Health and Contraception
Canadian institutionsPublic Health OntarioUniversity of Toronto
Fundersnot available
KeywordsMisoprostolAbortionUnsafe abortionAbortion lawMedicineSri lankaMedical abortionContext (archaeology)Family medicineEconomic growthFamily planningPolitical scienceSocioeconomicsPopulationEnvironmental healthPregnancySociologyTanzaniaGeography

Abstract

fetched live from OpenAlex

Misoprostol, a WHO essential medicine indicated for labour induction, management of miscarriage and post-partum haemorrhage, as well as for induced abortion and treatment of post-abortion complications, came up for registration in Sri Lanka in December 2010. The decision on registration was postponed, indefinitely. This has wide-ranging implications, as misoprostol is widely available and used, including by health professionals in Sri Lanka, without guidance or training in its use. This paper attempts to situate the failure to register misoprostol within the broader context of unsafe abortion, drawing on data from interviews with physicians and health policymakers in Sri Lanka. It demonstrates how personal opposition to abortion infiltrates policy decisions and prevents the issue of unsafe abortion being resolved. Any move to reform abortion law and policy in Sri Lanka will require a concerted effort, spearheaded by civil society. Women and communities affected by the consequences of unsafe abortion need to be involved in these efforts. Regardless of the law, women will access abortion services if they need them, and providers will provide them. Decriminalizing abortion and registering abortion medications will make provision of abortion services safer, less expensive and more equitable.RésuméLe misoprostol, médicament essentiel de l'OMS indiqué pour le déclenchement du travail, la prise en charge des fausses-couches et des hémorragies du post-partum, ainsi que pour l'interruption de grossesse et le traitement des complications de l'avortement, aurait dû être enregistré à Sri Lanka en décembre 2010. La décision sur son enregistrement a été reportée, indéfiniment, ce qui a de vastes conséquences car le misoprostol est disponible et utilisé largement, notamment par les professionnels de la santé à Sri Lanka, sans conseils ni formation à son utilisation. Cet article tente de placer le non-enregistrement du misoprostol dans le contexte plus large de l'avortement à risque, se fondant sur des données recueillies lors d'entretiens avec des médecins et des décideurs à Sri Lanka. Il démontre comment l'opposition personnelle à l'avortement influence les décisions politiques et empêche de résoudre le problème de l'avortement à risque. Toute mesure pour réformer la loi et la politique sur l'avortement exigera un effort concerté, dirigé par la société civile. Les femmes et les communautés touchées par les conséquences de l'avortement à risque doivent être associées à ces activités. Quelle que soit la loi, si elles en ont besoin, les femmes auront accès aux services d'avortement et les prestataires les leur fourniront. En dépénalisant l'avortement et en enregistrant les médicaments, on rendra les services d'avortement plus sûrs, moins onéreux et plus équitables.ResumenMisoprostol, uno de los medicamentos esenciales de la OMS indicado para inducción del parto, manejo de pérdidas del embarazo y hemorragia posparto, así como para aborto inducido y tratamiento de las complicaciones postaborto, fue considerado para ser registrado en Sri Lanka en diciembre de 2010. La decisión fue aplazada por tiempo indefinido. Esto tiene implicaciones de gran alcance, ya que en Sri Lanka el misoprostol está disponible y es utilizado extensamente, incluso por profesionales de la salud, sin orientación o capacitación en su uso. Este artículo, basado en datos de entrevistas con profesionales médicos y formuladores de políticas de salud en Sri Lanka, intenta situar el no registrar el misoprostol en el contexto más amplio de aborto inseguro. Se demuestra cómo la oposición personal al aborto infiltra en las decisiones de políticas e impide que se resuelva el problema de aborto. Todo intento de reformar la ley y políticas referentes al aborto en Sri Lanka requerirá un esfuerzo concertado, encabezado por la sociedad civil. Las mujeres y comunidades afectadas por las consecuencias del aborto inseguro deben participar en estos esfuerzos. Independientemente de la ley, las mujeres obtendrán servicios de aborto si los necesitan y los prestadores de servicios se los proporcionarán. Si se despenaliza el aborto y se registran los medicamentos para inducir el aborto, la prestación de servicios de aborto será más segura, menos costosa y más equitativa.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Qualitative · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.043
Threshold uncertainty score0.090

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0030.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.001
Science and technology studies0.0110.017
Scholarly communication0.0070.002
Open science0.0000.004
Research integrity0.0020.003
Insufficient payload (model declined to judge)0.0050.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.022
GPT teacher head0.331
Teacher spread0.309 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designQualitative
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations41
Published2012
Admission routes1
Has abstractyes

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