Brazilian obstetrician-gynecologists and abortion: a survey of knowledge, opinions and practices

BACKGROUND: Abortion laws are extremely restrictive in Brazil. The knowledge, opinions of abortion laws, and abortion practices of obstetrician-gynecologists can have a significant impact on women's access to safe abortion. METHODS: We conducted a mail-in survey with a 10% random sample of obstetrician-gynecologists affiliated with the Brazilian Federation of Obstetricians and Gynecologists. We documented participants' experiences performing abortion under a range of legal and illegal circumstances, and asked about which abortion techniques they had experience with. We used chi-square tests and crude logistic regression models to determine which sociodemographic, knowledge-related, or practice-related variables were associated with physician opinion. RESULTS: Of the 1,500 questionnaires that we mailed out, we received responses from 572 (38%). Less than half (48%) of the respondents reported accurate knowledge about abortion law and 77% thought that the law should be more liberal. One-third of respondents reported having previous experience performing an abortion, and very few of these physicians reported having experience with manual vacuum aspiration (MVA) or with misoprostol with either mifepristone or methotrexate. Physicians that favored liberalization of the law were more likely to have correct knowledge about abortion law, and to be in favor of public funding for abortion services. CONCLUSION: Brazilian obstetrician-gynecologists need more information on abortion laws and on safe, effective abortion procedures

Park isolation in anthropogenic landscapes: land change and livelihoods at park boundaries in the African Albertine Rift

Landscapes are changing rapidly in regions where rural people live adjacent to protected parks and reserves. This is the case in highland East Africa, where many parks are increasingly isolated in a matrix of small farms and settlements. In this review, we synthesize published findings and extant data sources to assess the processes and outcomes of park isolation, with a regional focus on people’s livelihoods at park boundaries in the Ugandan Albertine Rift. The region maintains exceptionally high rural population density and growth and is classified as a global biodiversity hotspot. In addition to the impacts of increasing numbers of people, our synthesis highlights compounding factors—changing climate, increasing land value and variable tenure, and declining farm yields—that accelerate effects of population growth on park isolation and widespread landscape change. Unpacking these processes at the regional scale identifies outcomes of isolation in the unprotected landscape—high frequency of human-wildlife conflict, potential for zoonotic disease transmission, land and resource competition, and declining wildlife populations in forest fragments. We recommend a strategy for the management of isolated parks that includes augmenting outreach by park authorities and supporting community needs in the human landscape, for example through healthcare services, while also maintaining hard park boundaries through traditional protectionism. Even in cases where conservation refers to biodiversity in isolated parks, landscape strategies must include an understanding of the local livelihood context in order to ensure long-term sustainable biodiversity protection