![]() My organization, Global Fund for Women, supports many organizations that provide reproductive health care and which feel the pinch of this policy on their operations. Under Trump, the policy covers all $8.8 billion in US global health aid, nearly 15 times the reach of previous iterations. Since then, each Democratic president has rescinded it and each Republican president has reinstated it. The policy, known as the Mexico City Policy and dubbed the global gag rule by women’s groups to reflect the act’s intentions and impact, was first introduced by President Ronald Reagan in 1984. The United States is the world’s largest donor to global health, and abortion-related services are often integrated into general health care involving HIV, contraceptives, and families. ![]() In late March 2019, the Trump administration expanded this policy to include subcontractors serving groups that provide or discuss abortion. (Photo by Alison Wright/Global Fund for Women)Īs one of his first acts as president of the United States, Donald Trump reinstated a policy prohibiting organizations from receiving US government aid if they provide services, referrals, and advocacy related to abortion abroad. More research and policy analysis exploring the GGR's development and its implementation on the ground will improve knowledge on GGR consequences, and potentially shape its reform.Ībortion Global Health Global gag rule Health systems Mexico City policy.“The solidarity among the organizations who are addressing safe abortion has grown” under the global gag rule, says Rakshya Paudyal, a program manager with Beyond Beijing Committee, a Nepal-based feminist human rights organization. More peer-reviewed and quantitative research measuring and monitoring the policy's impact on health outcomes are needed. The GGR's development and implementation was consistently associated with poor impacts on health systems' function and outcomes. Only three studies (6.9%) quantified associations between the GGR and abortion rates, concluding that the policy does not decrease rates of abortion. Sources reported on the impact of the GGR on HIV and AIDS programs, advocacy and coalition spaces, and maternal and child health. funding (21 articles) were often related. The frequently reported impacts on family planning delivery systems (34 articles) and the loss of U.S. The misunderstanding, miscommunication, and chilling effect of the policy underpinned the GGR's impacts. Overall, 80% of the identified sources were qualitative. The searches yielded 1355 articles, of which 43 were included. These publications reported on impacts of the global gag rule on 14 domains in global health. Organizations and individuals working on GGR research and impact were also contacted to access their works from the same time period. Fourteen peer-reviewed databases and 25 grey literature sources were searched for publications between January 1984 and October 2017. The review utilized Arksey and Malley's five-stage methodological framework to conduct a scoping review. This is the first time that all of the existing literature on the policy's impact has been synthesized into one article and comprehensively reviewed. In light of the aforementioned expansion, this scoping review aimed to describe and map the impacts of the GGR on global health, which in turn would identify research and policy gaps. Historically, it has only been attached to family planning funding, until 2017 when a presidential memorandum expanded the policy to nearly all US$8.8 billion in global health foreign assistance. The policy became known as the global gag rule (GGR) due to its silencing effect on abortion advocacy. funds to provide, counsel on, or refer for abortion services as a method of family planning, or advocate for the liberalization of abortion laws- except in cases of rape, incest, and life endangerment. international family planning assistance from using their own, non-U.S. ![]() federal policy that has prohibited foreign nongovernmental organizations that receive U.S. ![]()
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