Papers by Jane Cottingham
Bulletin of The World Health Organization, Jun 3, 2010
Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se fa... more Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. املقالة. لهذه الكامل النص نهاية يف الخالصة لهذه العربية الرتجمة
Bulletin of The World Health Organization, Jul 1, 2010
We describe the historical development of how maternal and neonatal mortality in the developing w... more We describe the historical development of how maternal and neonatal mortality in the developing world came to be seen as a public-health concern, a human rights concern, and ultimately as both, leading to the development of approaches using human rights concepts and methods to advance maternal and neonatal health. We describe the different contributions of the international community, women's health advocates and human rights activists. We briefly present a recent effort, developed by WHO with the Harvard Program on International Health and Human Rights, that applies a human rights framework to reinforce current efforts to reduce maternal and neonatal mortality.
Reproductive Health Matters, 2007
Best Practice & Research in Clinical Obstetrics & Gynaecology, Apr 1, 2002
An estimated 60 000±70 000 women die annually from complications of unsafe abortion and hundreds ... more An estimated 60 000±70 000 women die annually from complications of unsafe abortion and hundreds of thousands more suer long-term consequences which include chronic pelvic pain and infertility. The reasons for the continuing high incidence of unwanted pregnancy leading to unsafe abortion include lack of access to, or misuse of and misinformation about, eective contraceptive methods, coerced sex which prohibits women from protecting themselves, and contraceptive failure. Unsafe abortion is closely associated with restrictive legal environments and administrative and policy barriers hampering access to existing services. Vacuum aspiration and medical methods combining mifepristone and a prostaglandin for early abortion are simple and safe. For second trimester abortion, the main choices are repeat doses of prostaglandin with or without prior mifepristone, and dilatation and evacuation by experienced providers. Strategies for preventing unsafe abortion include: upgrading providers' skills; further development of medical methods for pregnancy termination and their introduction into national programmes; improving the quality of contraceptive and abortion services; and improving partner communication.
Global Public Health, Dec 24, 2014
Since the International Conference on Population and Development, definitions of sexuality and se... more Since the International Conference on Population and Development, definitions of sexuality and sexual health have been greatly elaborated alongside widely accepted recognition that sexual health requires respect, protection and fulfilment of human rights. Considerable progress has also been made in enacting or changing laws that affect sexuality and sexual health, in line with human rights standards. These measures include legal guarantees against non-discrimination and violence, decriminalisation of consensual sexual conduct and guaranteeing availability, accessibility, acceptability and quality of sexual health information and services to all. Such legal actions have had positive effects on health and specifically on sexual health, particularly for marginalised populations. Yet in all regions of the world, laws still exist which jeopardise health, including sexual health, and violate human rights. In order to ensure accountability for the rights and health of their populations, states have an obligation to bring their laws into line with international, regional and national human rights standards. These rights-based legal guarantees, while insufficient alone, are essential for effective systems of accountability, achieving positive sexual health outcomes and the respect and protection of human rights.
The involvement of civil society in the attainment of the International Conference on Population ... more The involvement of civil society in the attainment of the International Conference on Population and Development (ICPD) Program of Action has been clearly and increasingly visible. This has been exemplified in the participation of nongovernmental organizations (NGOs) in the ICPD +5 review which started at the national level continued through consultations and ended with the NGO Forum that took place in The Hague Netherlands February 6-7 1999. This report highlights the discussions of this NGO Forum. Chapters present examples of good practices obstacles that still need to be overcome and the critical next steps that still have to be taken in order to make the ICPD commitment a reality. The report sets out what NGOs believe should be included in their own agenda and those of others for future action.
Reproductive Health Matters, 2015
The politics of population control and its sometimes coercive methods in developing countries doc... more The politics of population control and its sometimes coercive methods in developing countries documented during the 1960s, 70s and 80s, gave rise to strong opposition by women's groups, and put into question the safety of contraceptive methods that were being developed and introduced into countries. In 1991, the Special Programme on Human Reproduction at the World Health Organization, a research programme focused on development of new methods and safety assessments of existing fertility regulation methods, started a process of "dialogue" meetings between scientists and women's health advocacy groups which lasted for nearly a decade. This paper describes the process of these meetings and what they achieved in terms of bringing new or different research topics into the agenda, and some of the actions taken as a result.
Reproductive Health Matters, 2011
The range of medicines and technologies that are essential for sexual and reproductive health car... more The range of medicines and technologies that are essential for sexual and reproductive health care is well established, but access to them is far from universally assured, particularly in less developed countries. This paper shows how the pharmaceutical industry plays a major role in the lack of access to essential medicines for sexual and reproductive health care, by a) investing in products for profit-making reasons despite their negative health impact (e.g. hormone replacement therapy), b) marketing new essential medicines at prices beyond the reach of countries that most need them (e.g. HPV vaccines), and c) failing to invest in the development of new products (e.g. microbicides and medical abortion pills). Small companies, some of them non-profit-making, struggle to fill some of that demand (e.g. for female condoms). International patent protection contributes to high prices of medicines, and while international agreements such as compulsory licensing under TRIPS and the Medicines Patent Pool allow for mechanisms to enable poorer countries to get access to essential medicines, the obstacles created by "big pharma" are daunting. All these barriers have fostered a market in substandard medicines (e.g. fake medical abortion pills sold over the internet). An agenda driven by sexual and reproductive health needs, based on the right to health, must focus on universal access to essential medicines at prices developing countries can afford. We call for greater public investment in essential medicines, expanded production of affordable generic drugs, and the development of broad strategic plans, that include affordable medicines and technologies, for addressing identified public health problems, such as cervical cancer.
Sexually Transmitted Infections, Aug 1, 1992
Objectives-Chlamydia trachomatis is now recognised as a major sexually transmitted disease; oral ... more Objectives-Chlamydia trachomatis is now recognised as a major sexually transmitted disease; oral contraceptive use is rapidly increasing particularly in developing countries. There are thus important public health implications of the many reports that isolation of C trachomatis is more frequent among users of oral contraceptives. The aim of this analysis was to assess the strength and consistency of this association by summarising published studies between 1972 and 1990. to be exposed to C trachomatis and other STDs. The protective effect of barrier methods emphasizes the continued need for promoting traception. barrier methods of con
Gender & Development, May 4, 2018
The title of this book had me both startled and intrigued. One does not tend to think of abortion... more The title of this book had me both startled and intrigued. One does not tend to think of abortions as being 'happy'. And indeed, this is one of the main arguments around which the book is fashioned: that social, cultural, political, and even economic representations of abortion over the past four decades have emphasised the putative negative effects of abortion on women. The dominant 'emotional script' that impinges on women, the author argues, depicts abortion as an incredibly difficult choice made in response to extraneous circumstances that are beyond the woman's immediate control; it requires women to justify their abortion, preferably by citing the best interests of their potential children, to grieve their lost children after abortion, and to keep their abortions secret out of a sense of shame or guilt. (Introduction, p. 1)
Bulletin of The World Health Organization, Aug 1, 2010
Sexual and reproductive health matters, 2019
Reproductive Health Matters, 1993
Various practices keep women from receiving and using contraception. These medical barriers inclu... more Various practices keep women from receiving and using contraception. These medical barriers include those pertaining to eligibility process and regulatory and provider bias. Eligibility barriers place too strict criteria on what women may use a particular contraceptive. For example severe migraine headaches are a relative contraindication for oral contraceptives (OCs) but some community-based distribution programs include headaches without being specific on their checklist resulting in denying OCs to women who have had a recent headache. Blood tests to rule out liver and cardiovascular diseases as a prerequisite for a prescription of combined OCs in some West African countries represent a process hurdle. Yet just a brief medical history can identify women at risk of these diseases. Restricting IUD insertion to physicians in some countries is another example of a medical barrier. Family planning providers or program managers sometimes determine themselves what methods are best suited for various women. This provider bias essentially eliminates womens choice of methods. Until 1992 the US Food and Drug Administration (FDA) had not approved the 3-month injectable contraceptive method Depo-Provera despite many studies confirming its safety. The lack of FDA approval prevented other countries from approving it. Despite 30 years of OC use worldwide Japan still does not allow OC use. According to a WHO survey of 50 collaborating centers the most common medical barrier to contraceptive use is requiring women who use OCs and IUDs to return for follow-up examinations more often than is necessary. This recent survey concludes that no overall standardized information about contraceptives their side effects and who can and cannot use them safely exists. WHO and other groups are developing internationally accepted guidelines to counteract conflicting information and outdated criteria for contraceptive delivery.
Bulletin of The World Health Organization, Jul 1, 2010
Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se fa... more Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. املقالة. لهذه الكامل النص نهاية يف الخالصة لهذه العربية الرتجمة
Bulletin of The World Health Organization, Aug 1, 2008
Bjog: An International Journal Of Obstetrics And Gynaecology, Feb 1, 2008
Increasing attention has been given to women’s sexual and reproductive health and rights in the p... more Increasing attention has been given to women’s sexual and reproductive health and rights in the past decade. This is thanks partly to the impetus given by international conferences such as the 1993 Vienna Conference on Human Rights, at which women’s rights were articulated for the first time, the International Conference on Population and Development (ICPD) in Cairo in 1994 and the Fourth World Conference on Women in Beijing in 1995. The consensus documents from ICPD (1994 Programme of Action of ICPD) and Beijing (1995 Beijing Platform for Action) clearly articulated the need for women to have access to sexual and reproductive health services, including those for family planning, antenatal and delivery care, safe abortion where legal, postabortion care and treatment for sexually transmitted infections. They further recognised that refugee and internally displaced populations have particular reproductive health needs that must be met. These international agreements also stress the right of women to be free from all forms of violence and coercion. They have highlighted the multiple forms of violence against women, including intimate partner violence, sexual coercion, exploitation and rape in 'peaceful' times as well as during conflict situations. Language: en
Elsevier eBooks, 2008
The social norms and values that govern what women and men do and how they behave have an extensi... more The social norms and values that govern what women and men do and how they behave have an extensive impact on sexual and reproductive health. Biologically, women and men are differently susceptible to certain conditions such as sexually transmitted infections, but gender dimensions can significantly magnify such vulnerability through specific behaviors that are socially acceptable (or not acceptable), through access (or lack of it) to essential resources, through the ways in which institutions perceive and treat men and women, and through laws that may uphold gender inequalities or not protect one sex or the other against injustices.
Practical Action Publishing eBooks, 1984
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Papers by Jane Cottingham