Category: Uncategorized

Icon Right Caret return to previous page

All Insights

Roe v. Wade in the Global Context of Abortion Policies

October 21, 2022

This A3 Insights is published under our ‘Youth Perspectives’ series, where Population Council colleagues, fellows, interns, and partners under the age of 30 write a data-driven thought piece focused on their own interests and research areas.

This piece, authored by Tara Abularrage, GIRL Center Intern and MPH candidate at Columbia’s Mailman School of Public Health, centers the recent overturning of Roe v. Wade in the global landscape of abortion policies, outlines the implications of this decision on sexual and reproductive health and rights, and maps current abortion policy indicators across 113 LMICs using the A3 policy checklist.  

On June 24, 2022, the United States Supreme Court overturned Roe v. Wade, reversing decades of legal precedent. This makes the U.S. one of only four countries to remove protections for legal abortions in over 25 years. This attack on evidence-based policymaking and the rights of birthing people will have a broader impact on reproductive health, rights, and autonomy in the US and globally.  

Each year, approximately seventy-three million abortions take place worldwide. Access to safe and legal abortion has been increasingly recognized as a fundamental human right. In 1994, at the International Conference on Population and Development, 179 governments signed a program of action that includes a commitment to prevent unsafe abortion.

The World Health Organization (WHO) recognized unsafe abortions as a public health problem earlier in 1967, and subsequently developed technical and policy guidelines on safe abortions in 2003. As of 2020, comprehensive abortion care is included in the list of essential health care services published by the WHO. 

Significant progress has been made in global abortion policy in the last several decades indicating a growing global consensus that access to safe and legal abortion is both a human right and public health imperative. Over the last 25 years, at least 50 countries have liberalized their laws to improve access to abortion care and the majority of countries worldwide do not require parental authorization or notification for adolescents to access abortion services. However, 90 million birthing people of reproductive age still live in countries in which abortion is prohibited altogether. While most countries are taking steps to expand access and grounds for legal abortion, the US stands out with the recent overturning of Roe v. Wade and the enaction of more restrictive abortion policies that have followed.  

Need for an enabling environment, especially for marginalized populations 

An enabling regulatory and policy environment is crucial to ensuring that every birthing person has access to safe abortion care. Clear evidence shows that restrictions on access to safe abortion services do not reduce its incidence, but instead result in unsafe abortions and unwanted births. In fact, almost all deaths and morbidities from unsafe abortion occur in countries where abortion is severely restricted in law and/or in practice. The average rate of unsafe abortion is estimated to be more than four times higher in countries with more restrictive abortion laws than in countries with less restrictive laws. Additionally, abortion bans disproportionately harm historically marginalized people, including Black and Indigenous people and those from low-income communities.  

Given the unique set of circumstances and constraints faced by adolescents, enabling laws and policies are even more crucial to support their reproductive health and rights. When accessing abortion services, adolescents face a range of barriers unique to their age group including cost, stigma, lack of confidentiality, misinformation, parental consent or notification laws, and judicial authorization requirements. Such legal requirements prevent adolescents from making autonomous decisions and make it more difficult for them to seek and access abortion care. In Safe Abortion: Technical and Policy Guidance for Health Systems, the WHO recognizes that abortion laws should include protections for informed and voluntary decision-making, autonomy in decision-making, non-discrimination, and confidentiality and privacy for all pregnant people, including adolescents. Additionally, according to this guidance, third-party authorization requirements hinder adolescents’ access to abortion, and increase the likelihood that they will seek unsafe abortions.  

The average rate of unsafe abortion is estimated to be more than four times higher in countries with more restrictive abortion laws than in countries with less restrictive laws.

Before Roe was overturned, pregnant people under 18 seeking abortion care in the U.S. already had to navigate a series of legal and logistical hurdles to access appropriate care, and now, post Roe, these barriers have compounded and the process is even more difficult. However, there exists a vast network of activists, providers, and organizers helping pregnant youth access the care they need. While it is currently legal to travel out of state to obtain abortion care in the U.S., there is concern about child custody protection acts, which can criminalize transporting a minor across state lines to have an abortion without parental consent. While the Guttmacher Institute’s interactive map helps track the complex abortion policy landscape for each U.S. state, the Adolescent Atlas for Action (A3) Policy Checklist, created by the Population Council’s GIRL Center, maps national-level policies relevant to the lives of adolescents in 113 low- and middle-income countries (LMICs), including seven key abortion indicators. 

What does the global abortion policy landscape look like? 

Almost 90% of countries globally allow abortion, at minimum, when the pregnant person’s life is at risk. Abortion is legal to save the life of the pregnant person in 71% of the 113 LMICs included in the A3. While it’s critical to allow abortion in situations where pregnancy poses a risk to a pregnant person’s life, only permitting abortion on this ground is insufficient for guaranteeing birthing people’s human rights.

Only 23% of LMICs (27 countries) have policies allowing legal abortion at the request of the pregnant person, despite the WHO’s guidance that this is the only legal ground which “recognizes the conditions for a woman’s free choice.” These barriers are amplified for adolescents, with only 11% of LMICs (12 countries) that have policies to ensure abortion is legally available to adolescents without parental consent. Such restrictions prevent adolescents from making autonomous decisions and can inhibit them from seeking safe abortion care. 

To learn more about the A3 Policy Checklist, review this brief. 

Looking ahead 

Over the past several decades, incremental and transformative progress in securing legal rights and access to abortion has been made globally. Maintaining this momentum towards liberalizing abortion laws and creating enabling legal and policy environments is critical to ensuring reproductive rights and autonomy, particularly in light of the recent overturning of Roe v. Wade. It’s imperative that countries continue to enact evidence-based policies to support sexual and reproductive health, rights, and autonomy that strive to make abortion available upon request of the pregnant person and make such care universally affordable and accessible. Abortion laws and policies should pay particular attention to adolescents and prioritize their autonomy and access to safe abortion care. 

Icon Right Caret return to previous page

All Insights

Bringing the A3 to Life: A Resource to Drive Evidence-based Action 

July 26, 2022

The Population Council GIRL Center’s mission has always been data-driven. The programs we’ve built and the policies we’ve helped craft are guided by advanced demographic analyses that allow decision-makers to target specific issues and ensure that resources are used effectively. Our latest innovation in using data for change is the Adolescent Atlas for Action (A3), a set of free online tools for exploring gaps in adolescent education, health, and well-being around the world. 

For more insights on the launch of the A3, we asked Dr. Karen Austrian, Director of the GIRL Center, about her experience and perspectives on adolescent research and what the A3 can contribute. With 15 years of research experience with the Population Council focusing on empowering adolescents, Karen has been a champion of evidence-based policy action, especially in Africa.  

GIRL Center (GC): Congratulations on the launch of the A3! In your first year of stepping into the role as Director of the GIRL Center, this seems like a major milestone for your first set of accomplishments.  

Dr. Karen Austrian (KA): It’s has been a very exciting first year! The GIRL Center is working hard to champion evidence-based solutions for the challenges facing adolescents around the world today, and the A3 is an important step in our work of being a leading knowledge partner in this area of work. 

GC: We heard from Thoai about the initial motivation behind the A3. In your role as the GIRL Center Director, you led the process of bringing the idea to life. What makes the A3 unique compared to other data-based resources? 

KA: First is that many of the interactive databases out there are based on descriptive, single indicators. The A3 has analytical work already done behind the scenes to reflect our thinking on how vulnerabilities facing adolescents are interlinked. We know from experience in working with adolescent girls that thinking one indicator at a time limits our ability to effectively support girls. Because in real life, the wide range of indicators constantly interact. For instance, gender norms in a girl’s community impacts her education, which in turn affects her employment. Or another example is how a girl’s economic situation often shapes the decisions she makes about her sexual health, relationships, etc. The A3 aims to paint a more realistic, holistic picture of adolescent lives, by presenting the interlinkages of indicators. 

“The A3 paints a more realistic, holistic picture of adolescent lives, by presenting the interlinkages of indicators.”

Secondly, the data in the A3 goes beyond national level data and dives into subnational level data. National level data masks where pockets of extreme marginalization and vulnerabilities exist. Relying on national averages alone may also overlook geographic disparities within a country. There are still limits to subnational data that is available but this will continue to be a critical area of work in progress. 

GC: Before taking on the role as Director of the GIRL Center, you worked at the Population Council for 15 years as a researcher focusing on adolescent girls. From a researcher’s perspective, how can A3 strengthen or contribute to ensuring that data drives policies and actions for adolescents? 

“a tool that can be utilized to not only extend the partnership between research and policy, but also to strengthen capacity building”

KA: From my experience, the key to getting policy makers to utilize research at the country or local level is to build a relationship with them and act as a knowledge partner. Being available to share key information more broadly – rather than focusing on sharing specific research studies or journal articles – with the data that exists has been important. Furthermore, presenting evidence that is relevant to the context in a country or region is central to connecting research to policy in a holistic way. Population Council Kenya researchers, for example, have participated in the adolescent health strategy meetings of the Presidential Policy and Strategy Unit (PASU) to advise on indicators for the strategy. 

The A3 makes our role as a knowledge partner easier and aids decision makers. Before, we had to undertake additional studies to apply our core research to specific contexts to connect the dots. Now with the A3, contextualized evidence at the national and subnational levels and a snapshot of how prominent factors in a community are interrelated are all available online. For policy makers and government officials, the A3 can make evidence-informed decision-making less daunting. At the same time, the A3 will be a tool that can be utilized to not only extend the partnership between research and policy, but also to strengthen capacity building.  

GC: What is your vision for the A3 over the next five years? How does this fit into your vision for the GIRL Center’s next five years? 

KA: I hope the A3 will be a living resource that continues to grow and be responsive to the evolving needs of users. I envision the A3 to put data and evidence into the hands of drivers of change and innovations, ranging from policy makers to program designers and to adolescents themselves.  

Similarly, my vision for the Center is to become the go-to place for data and evidence-informed insights on adolescent girls. Having the A3 is key for the Center’s belief that adolescent girls are at the nexus of the world’s pressing issues, as the platform can help bring together people from different countries, sectors, and roles in helping adolescent girls through evidence-based solutions. The A3 can be a helpful resource, guide, or even a conversation starter that draws on the GIRL Center and Population Council’s multi-decade history of knowledge and expertise in this field. 

“I envision the A3 to put data and evidence into the hands of drivers of change and innovations, ranging from policy makers to program designers and to adolescents themselves.”

GC: Thank you for sharing your perspectives, Karen! 

We encourage all our readers to visit the new Adolescent Atlas for Action (A3), and share it with colleagues working on adolescent wellbeing. Reach out to the GIRL Center at a3@popcouncil.org to follow up or ask additional questions. 

Icon Right Caret return to previous page

All Insights

Seeing the Bigger Picture: How the New Adolescent Atlas for Action (A3) Revolutionizes Our Approach to Adolescent Wellbeing  

The Population Council GIRL Center’s mission has always been data-driven. The programs we’ve built and the policies we’ve helped craft are guided by advanced demographic analyses that allow decision-makers to target specific issues and ensure that resources are used effectively. Our latest innovation in using data for change is the Adolescent Atlas for Action (A3), a set of free online tools for exploring gaps in adolescent education, health, and well-being around the world.  

Today, we sat down with Dr. Thoai Ngo, our VP for Social and Behavioral Science, the founder of the GIRL Center, and the creative force behind the A3. In this Q&A, he walks us through the A3’s guiding philosophy and why it’s so important for data to be publicly accessible to generate actionable insights.  

GIRL Center (GC): The A3 officially launched this week, fulfilling a goal you’ve pursued since the creation of the GIRL Center. Can you walk us through the idea behind it? 

Dr. Thoai Ngo (TN): Of course! First, I want to offer my congratulations to everyone at the GIRL Center for this massive achievement. Alongside our partners, everyone involved deserves all the credit in the world for getting this off the ground.  

In terms of where the A3 comes from, it’s really a continuation of the work we started in 2017 when we first launched the GIRL Center. We envisioned it as a one-stop-shop for all available data and evidence on adolescents, making information available and accessible to everyone outside of the bubble of scientific research. The big problem we had was democratizing the data—getting it outside of the walls of academia and research institutions. Usually, scientists collect data from low- and middle-income countries, analyze it at universities and institutes in high-income countries, and then publish it in journal articles that are locked behind paywalls. It’s hard for anyone outside those circles to get it or use it.  

“A one-stop shop for all available data and evidence on adolescents, making information available and accessible to everyone outside the bubble of scientific research.”

Our first step toward solving that problem was the Adolescent Data Hub, a predecessor to the A3. It is the world’s largest open-access catalogue for existing data on adolescents, and it was a big step forward. But I still felt that it didn’t do everything we needed: decision-makers in government, healthcare, and education don’t just need to be able to access the data. They need to be able to understand it quickly and easily in a way that’s relevant to their choices around funding and policymaking. The kind of information they need is fundamentally different from what scientists work with. These decision-makers frequently need access to quick data points on where adolescents are living, how they are faring, and who should be targeted with which programs and policies.  And that’s how we got to the idea of the A3. 

GC: So, the motivation for the A3 is to fill that gap? 

TN: Right. Everything about the platform is designed to make it useful—it isn’t just a portal of information, it’s a set of custom-built tools for answering specific questions. It isn’t meant to be used by just researchers, it’s specifically designed for people working to implement adolescent programs and decision-makers in government or the private sector to be able to quickly get the knowledge they need to craft investment cases or public policies.  

“Designed for people working to implement adolescent programs and decision-makers to quickly get the knowledge they need to craft investment cases or public policies.”

That’s why we built it the way we did. The A3 is a data platform designed like an atlas, covering a huge range of data points on adolescent issues. It gives users the specific information that they need in the moment but also provides a holistic picture of young people’s lives instead of breaking down the information into separated categories like “education” or “health.” For instance, if you’re interested in adolescent education, you’ll be able to learn about the gendered barriers negative affecting education outcomes for girls, like child marriage, pregnancy, and violence.  

What this means is that anyone can use the A3 to put together a bigger story that’s more compelling than any isolated statistics at the global level or at regional, national, or sub-national hotspots. Another neat feature in the A3 is that it illustrates policy gaps by overlaying issues facing adolescents with existing national policies. You can see what’s being done about a particular problem, which makes it a lot easier to figure out what other steps we might need to take. 

GC: Why is it important to focus on adolescent data in particular? 

TN: Because it’s a gap in our knowledge. Adolescence is a unique phase of growth. It’s different from the rapid physical growth of childhood and the long-term psychological growth of adulthood. It’s a complex combination of sexual and reproductive development, changes in gender identity, social power dynamics, and many other issues, all intertwined and all in transition. It’s the part of our lives that is the most dynamic, and yet it’s also the part we know the least about.  

There’s also a note of urgency here. Right now, the biggest generation of 1.8 billion young people in history are in the middle of their teenage years, and we owe it to them to do everything we can to help them thrive and grow into the leaders and change-makers the world needs right now.   

GC: What do you envision for the A3 over the coming years?  

TN: We want to change how people understand and explore issues of adolescent wellbeing. This goes back to the platform’s design. We want people to show up with a question, seamlessly find a tool that can answer it, then have the A3’s design naturally lead them on to other interlinked areas of knowledge. 

The longer-term vision is to strengthen that core function. We’re thinking about data triangulation and analytics from different sources, including informal ones coming from outside the realm of academic research. For example, how do we integrate population level data, environmental data, and survey data with data on access to social media and data about mobile phone use? Getting those combinations right can give us a much more complete and holistic picture of adolescent lives.  

“We want to change how people understand and explore issues of adolescent wellbeing.”

We’re also looking at ways to help users see trends that emerge over time—what’s changing, what’s likely to change, and how young people’s lives are being affected. Ultimately, the A3 will be doing its job if people working in adolescent health and wellbeing start to think in a broader, more intersectional way, moving beyond traditional single-outcome indicators and starting to imagine healthy adolescents as whole people with many overlapping needs. My hope is that insights from the A3 will bring people together across disciplines and sectors. We’re going to need that kind of collaboration and innovation in order to solve the intertwined challenges of the climate crisis, massive inequality, and widespread poverty that are faced by this rising generation.  

GC: Thank you for taking the time, Thoai!  

We encourage all our readers to explore the new Adolescent Atlas for Action (A3), and share it with colleagues working on adolescent wellbeing. Reach out to the GIRL Center at a3@popcouncil.org to follow up or ask additional questions.