sexual and reproductive health vulnerability in south america
DESCRIPTION
South America hosts many of the world’s most comprehensively restrictive abortion legislations, resulting in women facing tremendous hurdles to exercise their reproductive rights. Across the continent, millions of abortions are performed annually in unsafe conditions leading to the death of thousands of women die as a result.The aim of this project was to visually and geographically explore the reproductive rights of women in South America. By collecting multiple statistics and indicators, including criminalization of abortion and the accessibility to contraception for women of child bearing age, the countries of that region were thematic mapped.TRANSCRIPT
SEXUAL AND REPRODUCTIVE HEALTH VULNERABILITY
IN SOUTH AMERICA
Krystle Hinkson-Goodwin
Geographic Information Systems
Fall 2014
• 1/3 of all pregnancies worldwide are unplanned
• Its estimated that 25% of the global population lives in countries with highly restrictive abortion laws, including in South America
• Women in these countries are still prosecuted for having an illegal abortion, and abortion is oftentimes prohibited even in cases of rape, incest or when the pregnancy endangers the life of the woman
• Restrictive legislation on abortion violates a woman's agency and human rights based on the UN International Conference on Population and Development in Cairo, the Fourth World Conference on Women in Beijing and the Universal Declaration of Human Rights
Background
• Population of 756,000
• The only English-speaking country in the South
American continent
• A former British territory which gained
independence in 1966
• Divided into 10 administrative regions
• Multiracial population with Indo-Guyanese
representing 43.45%, Afro-Guyanese
accounting for 30.20%, Amerindians
representing, 9.16% people of “mixed
heritage”
• Georgetown, the capital, comprises 20.7% of
the total population
• The sole country in South America with legal
abortions
• One of the highest rates of HIV/AIDS, maternal
and infant mortality rates in the region
Abstract
According to the 2013 United States census, the global population reached approximately 7 billion and half of that population encompassed women (3.52 billion). The aim of this project was to visually and geographically explore the reproductive rights of women in South America. By collecting multiple statistics and indicators, including criminalization of abortion and the accessibility to contraception for women, the countries of South America were thematic mapped. Finally, a vulnerability map was created, by ranking the maternal and infant mortality rates, unmet need for family planning, and legal status of abortion, to assess the susceptibility of women within the region.
Introduction
South America hosts many of the world’s most comprehensively restrictive abortion legislations resulting in women facing tremendous hurdles to exercise their reproductive rights. Across the continent, millions of abortions are performed
annually in unsafe conditions leading to the death of thousands of women die as a result. Guyana is the lone English-speaking country in South America and the only nation where abortions are legal; while the country of Chile is the only South American nation-state providing no exceptions or extenuating circumstances for an abortion. Most other countries within the region grant exceptions however it is generally only in the case of saving the pregnant woman’s life. A report released by the Guttmacher Institute indicated, many of the women who are disproportionately affected by this are poor or rural, which leads them to often resort to seeking abortions with “inadequately trained practitioners who employ unsafe techniques or attempt to self-induce abortion using dangerous methods.” There are countless barriers that women in South America face just to keep their agency, however most of them are fear of legal repercussions, social stigma and excessive costs for obtaining safe abortions. This project seeks to show the varying levels of vulnerability of the reproductive healthy for women in South America.
This project also explore state of women’s sexual and reproductive health in the country of Guyana, an outlier in the region.
Data Synopsis
Data and Statistics were compiled from the following sources:
Administrative Boundaries, Regional Districts, Roads and Health facilities
Diva-Gishttp://www.diva-gis.org/gdata
Center for International Earth Science Information Network (CIESIN) http://dx.doi.org/10.7927/H4ST7MRB
Google Mapshttps://www.google.com/maps
Open Street Mapwww.openstreetmap.org/
GADM database of Global Administrative Areashttp://www.gadm.org/country
Sexual and Reproductive Statistics:
World Bank Data Portaldata.worldbank.org/
UN Data Portaldata.un.org/
Methodology & Analysis
The genesis of this spatial analysis project emerged from a curiosity to explore the cross-section and inter-linkages between reproductive rights and mortality rates. The project initiated with researching the necessary data for the below indicators which would be used for analysis. Collected indicators were procured from the United Nations Development Program site, the World Bank and the World Health Organization. These indicators were then compiled into a csv file on excel to be used as an attribute table the South American countries and Guyana shapefile boundaries downloaded on Diva-Gis. Once the shapefiles were ArcMap, I joined my csv to the files based on country names. Upon reviewing all of the compiled indicators when sorted from high to low it became clear, even before mapping, that what was anticipated as a success for women’s rights and what was hoped to be a reduced mortality rate due to the legality of abortion in Guyana the complete opposite was true. Guyana was shown to have the second highest rates of maternal mortality in South America, this led to my element of spatial analysis, which will be discussed later.
Before mapping the indicators, there was some troubleshooting that took place as several of the numerical values in my attributes table wouldn’t load. Therefore, I manually entered in the data for those fields using the editing tool as well as created risk rankings for each of the indicators for the vulnerability scale which would take into account the rankings of all prior indicators. For the vulnerability scale the previous rankings were added together to create a new risk numerical value.
VulnerabilityIndicators
Unmet need for contraception (% of married women ages 15-49)
Unmet need for contraception is the percentage of fertile, married
women of reproductive age who do not want to become pregnant
and are not using contraception.
Maternal mortality ratio (modeled estimate, per 100,000 live
births)
Maternal mortality ratio is the number of women who die from
pregnancy-related causes while pregnant or within 42 days of
pregnancy termination per 100,000 live births. The data are
estimated with a regression model using information on the
proportion of maternal deaths among non-AIDS deaths in women
ages 15-49, fertility, birth attendants, and GDP.
Mortality rate, infant (per 1,000 live births)
Infant mortality rate is the number of infants dying before
reaching one year of age, per 1,000 live births in a given year.
Criminalization of Abortion
Once the attribute table was completed, the continent of South
America was thematically mapped according to the indicators, with
the exception of infant mortality rates.
To include an element of spatial analysis, a separate more
comprehensive shapefile was downloaded from GADM which
included regional boundaries. This shapefile as well as one for roads
taken from Diva-Gis was then loaded into ArcMap. A new csv was
then created with information for the main clinics and hospitals in
Guyana. Clinics and hospitals were not listed on the Health Ministry
or National Government website for Guyana consequently I had to
individually comb through dozens of entries on Open Street Map and
Google Maps as there was no comprehensive list of healthcare
facilities (with official name and location).
A list of hospitals, clinics, their corresponding latitudinal/longitudinal
coordinates and district regions was then input into an excel csv and
another join was made to the Guyana shapefile. I then added a
population density raster into the table of contents and attempted to
convert it to a polygon using conversion tools however an error
appeared continuously thus forcing me to re-download the
population density for Guyana as an ascii, convert it to raster and then
convert the raster to a polygon. Once that was completed I went to
layer properties to map according to dot density.
When the population dot density was displayed on the Guyana shapefile, all
hospitals and clinics were mapped using the xy function and measured the
distance between coordinates and roads. This latter step proved to be
unnecessary because it is visually apparent that all of the mapped health facilities
are located near roads, which lends proof to the fact that Guyana’s high rates and
risks are not due to the population being unable to access their health facilities
but rather there is most likely a infrastructural component that is playing a lead
role here.
Results
The results of this project show that much of South America is at a relatively mid
to lower mid- range of mortality rates, which validates evidence that situation is
improving within the region however more still needs to be done. Women in
Bolivia and Guyana were shown to be most susceptible to sexual and
reproductive risk factors and the legalization of abortion does not necessarily
mean countries will have a lower maternal mortality rate or risks. As seen with
the case of Guyana, the mortality and vulnerability rates for women are not due
to inaccessibility to health facilities but rather a larger systemic problem. Several
main components should be considered for playing a lead role in this anomaly,
they include the country’s highly decentralized health care system, unavailability
of integrated health information system, the limited use of health information to
support governmental decision making, limited and dilapidated infrastructural
facilities, “difficult terrain and sparsely populated hinterland making delivery and
monitoring of health services difficult, insufficient human resources for health
and absence of a Human Resource Strategic Plan”.
Resources
1. Human Rights Watch., “International Human Rights Law and Abortion in Latin America”
2. Guttmacher Institute., “Facts on Abortion in Latin America And the Caribbean: In Brief”
3. RH Reality Check. “In Latin America and the Caribbean, Unmet Need for Contraception and Unsafe Abortion Are Widespread”
4. Ibid.
5. World Health Organization., “Country Cooperation Strategy: Guyana At a Glance”