The health, economic, and social effect of COVID-19 and its response on gender and sex: A literature review

Large-scale emergencies, like the ongoing COVID-19 pandemic, demonstrate pervasive effects across multiple sectors. There is a continually growing body of evidence demonstrating gender and sex differences in COVID-19 disease, as well as its health, social, and economic impacts. While online resources have worked to compile this evidence, there is a need to evaluate and synthesize the available gender- and sex-disaggregated data related to COVID-19. This literature review will systematically assess and compile current literature and evidence from different disciplines. We will include peer reviewed articles, clinical studies and reports, and relevant working papers using secondary data analyses and primary research methodologies. We will synthesize and describe the evidence on multiple outcomes of interest, including gender and sex differences in mortality, severity, treatment outcomes, exposure to violence, mental health and psychosocial support needs, and economic insecurity with COVID-19. These results can be used to inform policy, identify research gaps, and support recommendations for priority interventions

The global state of evidence on interventions to prevent child marriage

Growing recognition of the harmful effects of child marriage has placed its elimination on the global and national agenda. To address this problem, through the Girl Innovation, Research, and Learning (GIRL) Center, the Population Council reviewed the global state of evidence on what works to prevent child marriage. The research focuses exclusively on rigorously evaluated interventions—randomized controlled trial (RCT), quasi-experimental study, or a natural experiment—and incorporates new results not included in previous reviews. This research brief reports on the study’s findings about types of child-marriage interventions and approaches used, assesses what works best (and what does not work) to reduce child marriage, investigates the impact of interventions on other aspects of girls’ well-being, and reports the costs of implementing these interventions. The findings suggest that interventions incorporating an empowerment approach, either as the sole approach or in conjunction with another approach, demonstrated the greatest success in reducing child marriage

Male circumcision uptake, postoperative complications, and satisfaction associated with mid-level providers in rural Kenya

OBJECTIVE: The purpose of this study was to assess postoperative complications and patient satisfaction associated with mid-level provision of male circumcision in rural Kenya. METHODS: A prospective cohort study was conducted among children, adolescents, and adult men undergoing male circumcision from September 1, 2008 to December 4, 2008 at Marie Stopes International Kenya mobile outreach sites located in eight districts in the Nyanza and Western Provinces, Kenya. Male circumcision procedures were performed by registered nurses, surgical technicians, or nurse aides. Postoperative follow-up visits took place on the day of the procedure and at postoperative days 3, 7, and 30, with additional visits as necessary. Data on adverse events, healing conditions, satisfaction level, and resumption of activities were assessed at each follow-up visit. RESULTS: A total of 285 individuals were screened, and 240 underwent male circumcision procedures. All procedures were performed using the guided forceps technique by mid-level providers. At the first follow-up visit (postoperative day 3), 5.8% (n = 14) individuals did not return for post-surgical assessment. Retention rates at the second (day 7) and third (day 30) follow-up visits were 91.3% (n = 219) and 84.6% (n = 203), respectively. The prevalence of complications (moderate and severe adverse events) was 1.3% (3/240). At the first and second follow-up visits, 91.7% of patients (n = 220) were capable of resuming their daily activities, and 100% by day 30. The majority of patients (>99%) were satisfied with the procedure, counseling, and information received. CONCLUSION: Male circumcisions can be delivered safely and successfully by mid-level providers in rural settings with high client satisfaction, thereby increasing access to human immunodeficiency virus prevention services in Kenya

How are key demographic indicators related to COVID-19 reported in the United States: A data review protocol—Study description

The COVID-19 pandemic is evolving fast and affecting rich and poor countries; however, the social determinants of the health outcomes associated with COVID-19 have not been well characterized. While there is increasing discussion of COVID-19 disparities in the media, no systematic compilation of data exists that synthesizes what and how official reporting platforms disaggregate demographic indicators of COVID-19 testing, cases, hospitalizations, recoveries and deaths. This review will provide a comprehensive overview of what and how federal and local health officials report COVID-19 cases. Having this information nationally and subnationally can help health officials to deploy a more targeted response effort such as testing, treatment, and contact tracing. This information could be useful for future vaccine development. This data review can reveal gaps in our public health data system, which can lead to recommendations on how to improve data standardization, disaggregation, and reporting, particularly for tracking outbreaks. This protocol may be replicated in other countries to understand how demographic indicators are being reported and their relationship to COVID-19 health outcomes

Opinion: Ensure access to high-quality abortion care during and after the COVID-19 pandemic

As the COVID-19 pandemic continues to reshape our lives and health systems, Council Program Director Thoai Ngo and President of Ibis Reproductive Health Kelly Blanchard share their views on abortion care during these unprecedented times in an opinion piece for Thomson Reuters Foundation News. Citing two new evidence reviews on women’s ability to manage abortions with safe and effective medicines during early pregnancy, the authors support self-managed abortion during—and after—this pandemic as a method that puts less strain on health systems and allows women access who might be hampered by isolation and distancing mandated in response to COVID-19

Rethinking the Role of Demographers in Times of Crisis

The authors call on demographers to promote research transparency; invest in global, collaborative research centers; and find new and innovative ways of sharing findings in real time

Rapid review of community engagement and social mobilization strategies for COVID-19 response: Study description

This project is a rapid review of evidence on interventions intended to mobilize community-level action to control infectious disease outbreaks in low resource and humanitarian contexts. The primary aims are to provide a critical analysis of current evidence on community engagement in preparing for or responding to infectious disease outbreaks and other emergencies; and to identify approaches and practices that can inform efforts to address COVID-19-related risks in low resource settings. In addition to documenting lessons and potential good practices from past crises, we will identify critical gaps in current evidence

Comparing the World Health Organization-versus China-recommended protocol for first-trimester medical abortion: a retrospective analysis

OBJECTIVE: To compare the effectiveness, in terms of complete abortion, of the World Health Organization (WHO)- and the China-recommended protocol for first-trimester medical abortion. METHODS: A retrospective analysis of clinical data from women presenting for first trimester medical abortion between January 2009 and August 2010 at reproductive health clinics in Qingdao, Xi'an, Nanjing, Nanning, and Zhengzhou was conducted. One clinic in Qingdao administered the WHO-recommended protocol (200 mg mifepristone orally followed by 0.8 mg misoprostol buccally 36-48 hours later). Four clinics in the other locations provided the China-recommended procedure (Day 1: 50 mg of mifepristone in the morning, 25 mg in the afternoon; Day 2: 50 mg of mifepristone in the morning, 25 mg in the afternoon; Day 3: 0.6 mg oral misoprostol). Data on reproductive and demographic characteristics were extracted from clinic records, and complete termination was determined on day 14 (post-mifepristone administration). RESULTS: A total of 337 women underwent early medical abortion (167 WHO- and 170 China-recommended procedures). Complete abortion was significantly higher among women who had the WHO protocol than those who received the China protocol (91.0% vs 77.7%, respectively; P < 0.001). Women using the China-recommended protocol were three times more likely to require an additional dose of misoprostol than women using the WHO protocol (21.8% vs 7.8%, respectively; P < 0.001), and had significantly more bleeding on the day of misoprostol administration (12.5 mL vs 18.5 mL; P < 0.001). CONCLUSION: This clinical audit provides preliminary evidence suggesting the WHO-recommended protocol may be more effective than the China-recommended protocol for early medical abortion. A larger scale study is necessary to compare the methods' effectiveness and acceptability

Dynamics of IUD use in Vietnam: implications for family planning services at primary health care level

This study describes the dynamics of intrauterine device (IUD) use in Vietnam and implications for family planning services. A retrospective study was conducted among women who received IUD services in 2006–2009 at six commune health stations in three provinces. Women were interviewed about IUD use and switching behaviors. Of 1316 participants, 12.1% had discontinued IUD use at 12 months after insertion, 19.4% at 24 months, and 26.9% at 36 months. The highest rates of discontinuation were among older women and farmers/manual workers. Among 434 women who had an IUD removed, 49% cited health concerns as the main reason. Following removal, 70% switched to another contraceptive method (n = 306); of these, 15% switched to withdrawal, and 12% waited >2 months before adopting a new method. Dissatisfaction with IUD services was associated with high rates of discontinuation. Early discontinuation, delays in adopting new methods, and switching to withdrawal may contribute to unintended pregnancy among commune health station users in Vietnam

Effectiveness, safety, and acceptability of medical abortion at home vs. in the clinic: An updated systematic review in response to COVID-19

This document describes the protocol for an updated systematic review of the evidence comparing medical abortion practiced at home and in clinics in terms of effectiveness, safety and acceptability. We are updating Ngo et al.’s 2011 review given the importance of access to homemedication abortion during the COVID-19 pandemic. We will conduct a systematic search for randomized controlled trials and prospective cohort studies comparing home-based and clinic-based medical abortion. Successful abortion is the main outcome of interest. Side-effects, complications, and acceptability are secondary outcomes. Risk Ratios (RRs) and their 95% confidence intervals (CIs) will be calculated. Estimates will be pooled using a random-effects model