Bela Ganatra

Bela Ganatra
World Health Organization WHO | who · Department of Reproductive Health and Research (RHR)

About

141
Publications
51,637
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
4,980
Citations
Citations since 2017
66 Research Items
3311 Citations
20172018201920202021202220230200400600
20172018201920202021202220230200400600
20172018201920202021202220230200400600
20172018201920202021202220230200400600
Introduction
Bela Ganatra currently works at the Department of Reproductive Health and Research (RHR), World Health Organization WHO.

Publications

Publications (141)
Article
Full-text available
Background Global estimates of unsafe abortions have been produced for 1995, 2003, and 2008. However, reconceptualisation of the framework and methods for estimating abortion safety is needed owing to the increased availability of simple methods for safe abortion (eg, medical abortion), the increasingly widespread use of misoprostol outside formal...
Article
Full-text available
Background: Telemedicine is increasingly used to access abortion services. Objective: To assess the success rate, safety and acceptability for women and providers of medical abortion using telemedicine. Search strategy: We searched Pubmed, EMBASE, clinicalTrials.gov, and Web of Science up until November 10th 2017. Study criteria: We selected...
Article
Full-text available
Introduction Complications due to unsafe abortions are an important cause of morbidity and mortality in many sub-Saharan African countries. We aimed to characterise abortion-related complication severity, describe their management, and to report women’s experience of abortion care in Africa. Methods A cross-sectional study was implemented in 210 h...
Article
Full-text available
Consensus is lacking on the most appropriate indicators to document progress in safe abortion at programmatic and country level. We conducted a scoping review to provide an extensive summary of abortion indicators used over 10 years (2008–2018) to inform the debate on how progress in the provision and access to abortion care can be best captured. D...
Article
Full-text available
Background Unintended pregnancy and abortion estimates document trends in sexual and reproductive health and autonomy. These estimates inform and motivate investment in global health programmes and policies. Variability in the availability and reliability of data poses challenges for measuring and monitoring trends in unintended pregnancy and abort...
Article
Full-text available
Background Availability of quality-assured medical abortion medicines plays a crucial role in providing comprehensive abortion care. However, access to these medicines is still restricted for many abortion seekers. Increasing availability of affordable, quality-assured mifepristone and misoprostol is important to improve access to safe medical abor...
Article
Full-text available
Background: Despite the negative impact of unsafe abortions on women's health and rights, the degree of abortion safety remains strikingly undocumented for a large share of abortions globally. Data on how women induce abortions (method, setting, provider) are central to the measurement of abortion safety. However, health-facility statistics and di...
Article
Full-text available
Abstract Introduction The COVID-19 pandemic has negatively impacted health systems globally and widened preexisting disparities. We conducted a scoping review on the impact of the COVID-19 pandemic on women and girls’ access to and utilisation of sexual and reproductive health (SRH) services for contraception, abortion, gender-based and intimate pa...
Article
Full-text available
Introduction: Internationally comparable estimates of unintended pregnancy and abortion incidence can illuminate disparities in sexual and reproductive health and autonomy. Country-specific estimates are essential to enable international comparison, and to inform country-level policy and programming. Methods: We developed a Bayesian model which...
Article
Full-text available
Introduction Abortion-related complications are a significant cause of morbidity and mortality among women in many Latin American and Caribbean (LAC) countries. The objective of this study was to characterise abortion-related complication severity, describe the management of these complications and report women’s experiences with abortion care in s...
Article
Objective : To develop a minimum data set, known as a core outcome set, for future abortion randomized controlled trials. Study design : We extracted outcomes from quantitative and qualitative systematic reviews of abortion studies to assess using a modified Delphi method. Via email, we invited researchers, clinicians, patients, and healthcare org...
Article
Full-text available
Background: Health care for stigmatized reproductive practices in low- and middle-income countries (LMICs) often remains illegal; when legal, it is often inadequate, difficult to find and / or stigmatizing, which results in women deferring care or turning to informal information sources and providers. Women seeking an induced abortion in LMICs oft...
Article
Full-text available
Background Mifepristone and misoprostol are recommended for second trimester medical abortion but consensus is unclear on the ideal regimen. Objectives To systematically review randomized controlled trials (RCTs) investigating efficacy, safety, and satisfaction of medical abortion ≥ 12 weeks' gestation. Data sources We searched PubMed, Popline, E...
Preprint
Full-text available
Unintended pregnancy and abortion estimates are needed to inform and motivate investment in global health programmes and policies. Variability in the availability and reliability of data poses challenges for producing estimates. We developed a Bayesian model that simultaneously estimates incidence of unintended pregnancy and abortion for 195 countr...
Article
Full-text available
Comprehensive abortion care can be safely provided by a range of nonphysician health workers. Documenting existing strategies for successful task‐sharing can support implementation elsewhere.
Article
In 2015, the World Health Organization (WHO) published a guideline on the role of health workers in providing safe abortion and postabortion contraception, with evidence‐based recommendations on the range of providers who can perform interventions to provide safe abortion, postabortion care, and postabortion contraception. The WHO guideline is glob...
Article
Background: The advent of medical abortion has improved access to safe abortion procedures. Medical abortion procedures involve either administering mifepristone followed by misoprostol or a misoprostol-only regimen. The drugs are commonly administered in the presence of clinicians, which is known as provider-administered medical abortion. In self...
Article
Globally, many women undergo unsafe abortion, although abortion is extremely safe when done in accordance with recommended guidelines. Hence, many women suffer from abortion-related complications, and unsafe abortion remains a major cause of maternal mortality. The high percentage of unsafe abortion is attributed to the inability of women to access...
Article
Objectives: To assess the severity of complications following misoprostol used to induce abortion compared with other methods among women admitted for postabortion complications. Methods: A cross-sectional study of women who presented with complications of induced abortion at nine secondary and tertiary hospitals in South West Nigeria between Ap...
Article
The World Health Organization (WHO) Safe abortion: technical and policy guidance for health systems states that regulatory, policy, and programmatic barriers that hinder access to and timely provision of safe abortion care should be removed. Although some regulatory requirements facilitate access, where they act as barriers, they can deter women fr...
Article
Full-text available
Unsafe abortion continues to impact negatively on women’s health in countries with restrictive abortion laws. It remains one of the leading causes of maternal mortality and morbidity. Paradoxically, modern contraceptive prevalence remains low and the unmet need for contraception continues to mirror unwanted pregnancy rates in many countries within...
Article
Full-text available
Background: Estimates of pregnancies, abortions and pregnancy intentions can help assess how effectively women and couples are able to fulfil their childbearing aspirations. Abortion incidence estimates are also a necessary foundation for research on the safety of abortions performed and the consequences of unsafe abortion. Furthermore, periodic e...
Article
Full-text available
Objective: The study aimed to assess the use of misoprostol and complications associated with abortions in referral hospitals in Nigeria, a country with restrictive abortion laws. Methods: A cross-sectional study at nine referral hospitals in South-west Nigeria. Nine years' data were retrieved from medical records, including 699 induced abortion...
Article
Full-text available
Background Texts and interpretations on the lawfulness of abortion and associated administrative requirements can be vague and confusing. It can also be difficult for a woman or provider to know exactly where to look for and how to interpret laws on abortion. To increase transparency, the Global Abortion Policies Database (GAPD), launched in 2017,...
Article
Background: The World Health Organization (WHO) guidelines for safe abortion recommend medical abortion with mifepristone and misoprostol or surgical abortion with vacuum aspiration or dilation and evacuation as safe and effective options for women. However, no specific clinical considerations are stipulated within these guidelines for women livin...
Article
Full-text available
Background: Sri Lankan abortion law which dates back to the year 1883, and still unchanged, only allows a legal termination when the mother’s life is in danger. Many studies undertaken in the country estimates that even in the light of such a backdrop, and with a high contraceptive prevalence rate, many women attempt an abortion when faced with an...
Article
Full-text available
Introduction Defining and accurately measuring abortion-related morbidity is important for understanding the spectrum of risk associated with unsafe abortion and for assessing the impact of changes in abortion-related policy and practices. This systematic review aims to estimate the magnitude and severity of complications associated with abortion i...
Data
Table S2. A, risk of bias assessment for included RCTs; B, risk of bias assessment for prospective cohort studies (Medical TOP and facility‐based providers).
Article
Full-text available
Background We conducted a process evaluation to assess how the World Health Organization’s (WHO) Strategic Approach to strengthening sexual and reproductive health policies and programs (“the SA”) was used in 15 countries that requested WHO’s technical support in addressing unintended pregnancy and unsafe abortion. The SA is a three-stage planning,...
Article
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: Our primary objective is to assess the effectiveness and safety of medical versus surgical abortion among women living with HIV. Our secondary objectives are to: (1) assess abortion outcomes for both methods between women living with HIV and HIV-negative women a...
Article
Full-text available
Background Allowing a broader range of trained health workers to deliver services can be an important way of improving access to safe abortion care. However, the expansion of health worker roles may be challenging to implement. This study aimed to explore factors influencing the implementation of role expansion strategies for non-physician provider...
Article
Research has not kept abreast of women’s self-use of medical abortion, leaving many gaps in the scientific literature regarding the ideal conditions for safe and effective use. Therefore, our main objectives were to assess the research gaps highlighted during the conference, identify specific challenges to conducting research on medical abortion se...
Article
Full-text available
Background Despite being legally available in India since 1971, barriers to safe and legal abortion remain, and unsafe and/or illegal abortion continues to be a problem. Community health workers have been involved in improving access to health information and care for maternal and child health in resource poor settings, but their role in facilitati...
Article
Full-text available
Background: Previous systematic reviews have concluded that medical termination of pregnancy (TOP) provided by non-physician providers may be as effective and safe as when provided by physicians. Medical treatment of incomplete miscarriage by non-physicians, and treated women's acceptability with non-physician providers of TOP has not previously b...
Article
Background: Abortion is one of the most common events in women's healthcare worldwide. Currently there is no standardization for the selection and reporting of outcomes in abortion clinical trials. This heterogeneity in clinical trials can make it difficult to draw meaningful conclusions across studies. Objective: We aim to develop, disseminate,...
Data
Appendix S1. Search strategy.
Article
Full-text available
Introduction According to the WHO, abortion accounts for about 8% (4.7–13.2) of maternal mortality worldwide. In 2010, the WHO Multi-Country Survey (MCS) on Maternal and Newborn Health collected data on over 300 000 women who were admitted in health facilities to receive pregnancy-related care. Abortion data were partially captured by centring on s...
Article
Full-text available
Access to contraception reduces maternal deaths by preventing or delaying pregnancy in women not intending to be pregnant or those at higher risk of complications. However not all unintended pregnancies can be prevented through increase in contraceptive use and access to safe abortion is needed to prevent recourse to unsafe abortion. Safe abortion...
Article
Full-text available
Background: The contraceptive injectable is a safe and effective method that is used worldwide. With the variety of injectable delivery systems, there is potential for administration by the woman herself. Self-administration of the contraceptive injectable is the subject of this systematic review. Objectives: To assess how effective and safe the...
Poster
Full-text available
To determine the experiences with procuring an abortion and the subsequent care-seeking behaviour of women with unintended pregnancies.
Article
Full-text available
Background: Information about the incidence of induced abortion is needed to motivate and inform efforts to help women avoid unintended pregnancies and to monitor progress toward that end. We estimate subregional, regional, and global levels and trends in abortion incidence for 1990 to 2014, and abortion rates in subgroups of women. We use the res...
Article
Full-text available
Background: Incorrect knowledge of laws may affect how women enter the health system or seek services, and it likely contributes to the disconnect between official laws and practical applications of the laws that influence women's access to safe, legal abortion services. Objective: To provide a synthesis of evidence of women's awareness and know...
Article
Full-text available
Until recently, WHO operationally defined unsafe abortion as illegal abortion. In the past decade, however, the incidence of abortion by misoprostol administration has increased in countries with restrictive abortion laws. Access to safe surgical abortions has also increased in many such countries. An important effect of these trends has been that,...
Article
Full-text available
Objective: To assess the accuracy of assessment of eligibility for early medical abortion by community health workers using a simple checklist toolkit. Design: Diagnostic accuracy study. Setting: Ethiopia, India and South Africa. Methods: Two hundred seventeen women in Ethiopia, 258 in India and 236 in South Africa were enrolled into the stu...
Data
Medical abortion eligibility checklist tool. (PDF)