![]() ![]() This constrains knowledge generation for policy development and implementation and underestimates the ripple effect that the policy has had across health system areas.įacilitating a full mapping and understanding of what is known about the GGR’s impacts is critical because it can: ![]() Consequently, there is a fragmented understanding of the scope of the GGR’s impacts. There is sufficient evidence to determine that the GGR is harmful and that there is insufficient existing documentation of all the harms of the policy. 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. Īs part of a larger policy and research report on the GGR, researchers from the Center for Health and Gender Equity (CHANGE) 2 designed a scoping review that assembles existing evidence on the impact of the GGR on health systems from 1984 to 2017. The expanded GGR has triggered documentation of how this policy has and will affect global health and health systems. A handful of peer-reviewed studies and grey literature pieces have investigated the impact of previous implementations of the GGR on family planning programs. There is a diverse body of work on past, current, and projected GGR impact, including research articles, projects, reports, and case studies, produced by a wide range of sectors including academic institutions, governments, and health and civil society organizations. This includes funding for areas such as HIV and AIDS, maternal and child health (MCH), tuberculosis and malaria, gender-based violence (GBV), health systems strengthening, and water, sanitation and hygiene (WASH). On January 23, 2017, President Donald Trump reinstated the GGR, renaming it “Protecting Life in Global Health Assistance” (PLGHA), and laying the groundwork for the expansion of the policy to nearly all forms of global health assistance. Due to its gagging effect, the policy is often referred to as the Global Gag Rule (GGR), the term used throughout this article. The policy gags health providers from informing clients of their full range of reproductive options, as well as civil society organizations from advocating for legislative reform. Since 1984, the policy has been enacted by every Republican president and rescinded by every Democratic president. Under the policy, abortion is permissible in the cases of rape, incest, life endangerment of the woman, and as a “passive referral” 1. foreign assistance for family planning, the policy prohibits foreign non-governmental organizations (NGOs) from advocating for the liberalization of abortion laws or counseling on, referring for, or providing abortion services as a method of family planning. The MCP was instated in 1984 by President Ronald Reagan. System disruptions include loss of staff and resources and the reduction of health service provision for populations that need them. The Mexico City Policy (MCP) has significant impacts on global health and undermines already fragile health systems by disrupting system functions. 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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