Castro Arachu, Kabra Rita, Coates Anna, Kiarie James
International Health and Sustainable Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
World Health Organization, Geneva, Switzerland.
BMJ Glob Health. 2025 Feb 16;10(2):e016638. doi: 10.1136/bmjgh-2024-016638.
Acknowledging the integral role of bodily autonomy in advancing gender equality, our study aimed to assess the extent to which strategies used in postpartum and postabortion contraception have effectively equipped women, girls and gender-diverse individuals with the tools, knowledge and resources required to make autonomous decisions that align with their diverse life experiences.
We conducted a scoping review using the databases PubMed, EBSCOhost, EMBASE and SciSpace. We included implementation, evaluation and experimental studies published in any language between 2013 and 2023 and excluded studies not meeting these criteria. We used a WHO scale to determine the level of gender responsiveness.
We found 30 implementation, evaluation and experimental studies published in any language between 2013 and 2023. We categorised the strategies following the WHO scale as gender-transformative (4 studies), gender-specific (24 studies) and gender-sensitive (2 studies). None of the studies reported strategies hindering reproductive health and rights. All strategies involved women and girls, and none explicitly targeted gender-diverse people capable of childbearing.
This study highlights the importance of integrating gender-transformative activities into postpregnancy contraceptive strategies and underscores the necessity of understanding and addressing local gender norms and the broader health system context to promote bodily autonomy effectively. The findings suggest that success should not be solely measured by contraceptive uptake but also by how well interventions address gender-related barriers.
认识到身体自主权在推进性别平等方面的不可或缺的作用，我们的研究旨在评估产后和堕胎后避孕所采用的策略在多大程度上有效地为妇女、女孩和性别多元化个体提供了工具、知识和资源，使其能够做出符合其多样生活经历的自主决策。
我们使用PubMed、EBSCOhost、EMBASE和SciSpace数据库进行了一项范围综述。我们纳入了2013年至2023年间以任何语言发表的实施、评估和实验研究，并排除了不符合这些标准的研究。我们使用世界卫生组织的一个量表来确定性别响应水平。
我们发现了2013年至2023年间以任何语言发表的30项实施、评估和实验研究。我们按照世界卫生组织的量表将这些策略分类为性别变革型（4项研究）、针对性别的（24项研究）和对性别敏感的（2项研究）。没有一项研究报告有阻碍生殖健康和权利的策略。所有策略都涉及妇女和女孩，没有一项明确针对有生育能力的性别多元化人群。
本研究强调了将性别变革型活动纳入产后避孕策略的重要性，并强调了理解和应对当地性别规范以及更广泛的卫生系统背景以有效促进身体自主权的必要性。研究结果表明，成功不应仅以避孕措施的采用率来衡量，还应以干预措施解决与性别相关障碍的程度来衡量。
