Reproductive Health and Assisted Reproductive Technologies In Sub-Saharan Africa: Issues and Challenges (Sustainable Development Goals Series)

This book focuses on reproductive health rights and assisted reproductive technologies (ART) in sub-Saharan Africa. Each chapter is connected to the other by focusing on different aspects of ART as a means of achieving conception. Topics such as regulation of ART practices, surrogacy and specific aspects of ART, which are gradually becoming acceptable but largely unregulated in Africa, promises to be of interest to scholars, researchers and fertility practitioners. Research in the book take a rights based approach and ethical analysis of ART practice in sub-Saharan Africa by authors from diverse backgrounds bringing together law and society perspectives. Readers stand to gain new knowledge on the societal, legal, medical and psychological requirements, effects and challenges of reproductive health rights and ART in the African context. The book is also relevant to UN Sustainable Development Goal 3: Good Health and Well-being, given that it promotes and advocates for accessto reproductive healthcare for persons who have difficulty or are unable to conceive without medical assistance. Foreword Acknowledgements Contents Notes on Contributors Abbreviations List of Figures List of Tables Part I Reproductive Rights 1 Introduction—Reproductive Health Rights and Reproductive Technologies in Africa 2 Awareness of Reproductive Health Rights Among Married Women of Childbearing Age in Nigeria 2.1 Introduction 2.2 Literature Review 2.2.1 Reproductive Health and Rights 2.2.2 Legal Recognition and Protection of Reproductive Health Rights 2.2.3 Knowledge and Awareness of Reproductive Health Rights 2.2.4 Impediments to Realising Reproductive Health Rights in Nigeria 2.3 Methodology 2.3.1 Study Participants 2.3.2 Study Design and Data Collection 2.3.3 Ethical Consideration 2.3.4 Data Processing and Analysis 2.4 Result 2.5 Discussion 2.6 Limitations 2.7 Conclusion 2.8 Recommendations Bibliography 3 A Human Rights-Based Perspective to Sexual and Reproductive Health and Rights of African Senior Citizens 3.1 Introduction 3.2 The Marginalisation of Older People in the Sexual and Reproductive Health Discourse 3.3 Legal Framework Available for Protecting the Sexual and Reproductive Rights of African Older Persons 3.4 A Holistic Approach to Realising Older People's Sexual and Reproductive Rights in Africa 3.4.1 Affirmative Policies, Including Equal Access to Healthcare Services 3.4.2 Social Safety Nets for the Seniors 3.4.3 Involvement of Stakeholders to Generate Awareness and Strengthen the Research Capacity 3.5 Conclusion Bibliography 4 Reproductive Health Rights of Persons with Disabilities in Nigeria: A Legal or Cultural Flaw? 4.1 Introduction 4.2 Reproductive Health, Reproductive Health Rights and Persons with Disabilities 4.2.1 Reproductive Health 4.2.2 Reproductive Health Rights and Reproductive Rights 4.2.3 Persons with Disabilities 4.3 Legal Provisions for Reproductive Health Rights of Persons with Disabilities in Nigeria 4.4 Cultural Undertone 4.5 Recommendations 4.6 Conclusion Bibliography Part II Abortion 5 The Provision of Safe and Legal Abortion Services in South Africa: Expanding Access Through Telemedicine and Lessons Learned During the Covid-19 Pandemic 5.1 Introduction 5.2 Context of Abortion Service Provision in South Africa and COVID-19 5.2.1 The CTOPA and Context of Service Provision 5.2.2 The Effects of the Pandemic on Service Provision—Exacerbating Limited and Inequitable Access 5.3 Exacerbating Limits to Access: Documented Barriers to Access During the COVID-19 Pandemic 5.4 Increasing Access to Abortion Services: The Failure to Introduce Use of Telemedicine and Self-Managed Abortion Services 5.5 The Necessity of Telemedicine and Self-Managed Abortion Services in South Africa 5.6 Conclusion Bibliography 6 Reproductive Health Norms in West Africa: The COVID-19 Experience and a Path for the Future 6.1 Introduction 6.2 Legal Contexts of Reproductive Rights 6.3 Sexual and Reproductive Health During COVID-19 in West Africa 6.4 Sexual and Reproductive Health in Post-COVID-19 Economic Recovery Plans 6.5 Pathway to Informal Adaptive Governance Process to SRH in West Africa 6.6 Conclusion Bibliography 7 Reproductive Health Rights in Liberia: The Case of (Il)Legal and (Un)Safe Abortion 7.1 Introduction: Brief Background History 7.1.1 Structure and Flow 7.2 Literature Review: Definitions, Theories, Legal Framework 7.2.1 Definition and Explanation of Key Terms Reflecting Health Risks, Indicators, Impact, and Outcomes of (Un)Safe Abortion Practices in Liberia 7.2.2 Theorising Reproductive Health Rights of Adolescent and Teenage Girls 7.2.3 (Inter)national Instruments for Protecting Girls’ and Women’s Reproductive Rights in Liberia 7.3 Anecdotes and Reported Studies: Some Points for Discussion 7.4 Conclusion: Recommendation for Protection and Prevention Bibliography Part III Assisted Reproductive Technologies 8 Reproductive Health Rights and the Regulation of Assisted Reproductive Technologies (Art) Services in Nigeria 8.1 Introduction 8.2 Reproductive Health Rights in the Context of Human Rights 8.3 Reproductive Health Rights 8.4 Reproductive Health Rights in International Human Rights Law 8.4.1 Right to Life 8.4.2 Right to Health 8.4.3 Right to Liberty and Security 8.4.4 Reproductive Right 8.4.5 Right to Marry 8.4.6 Right to Privacy 8.4.7 Right to Equality 8.4.8 Freedom from Harmful Practices 8.4.9 Right Not to Be Subjected to Torture 8.4.10 Right to Be Free from Violence 8.4.11 Right to Reproductive Health Information 8.4.12 Right to Enjoy Scientific Progress 8.5 African Human Rights System and Reproductive Health Rights 8.6 Reproductive Health Rights in Nigeria 8.7 The Concept of Assisted Reproductive Technologies (ART) 8.7.1 In Vitro Fertilisation (IVF) 8.7.2 Ovarian Stimulation/Induction 8.7.3 Artificial Insemination (AI) 8.7.4 Intra Cytoplasmic Sperm Injection (ICSI) 8.7.5 Gamete Intra Fallopian Transfer (GIFT) 8.7.6 Zygote Intra Fallopian Transfer (ZIFT) 8.7.7 Preimplantation Genetic Diagnosis (PGD) 8.7.8 Surrogacy 8.8 Reproductive Health Rights and ART 8.9 ART in Nigeria 8.10 Regulatory Framework on ART in Nigeria 8.11 Challenges to the Enjoyment of Reproductive Health Rights to ART in Nigeria 8.12 Conclusion Bibliography 9 New Frontiers for Reproductive Health Rights: Contemporary Developments in the Regulation of Assisted Reproductive Technologies in South Africa 9.1 Introduction 9.2 Reproductive Health Rights in the South African Constitution 9.3 Relevant Legislation 9.4 Core Concepts in South African Reproductive Law 9.5 Gamete Donation 9.6 Surrogate Motherhood 9.7 Genetic Testing 9.8 Conclusion Table of Cases 10 Informed Consent and Ethical Considerations in Assisted Reproductive Technology in Nigeria: Options and Challenges 10.1 Introduction 10.2 Regulatory Framework for Informed Consent in Nigeria 10.3 Essential Components of Informed Consent 10.3.1 Capacity to Give Consent 10.3.2 Adequate Information 10.4 Models of Informed Consent 10.5 Materials and Methods 10.5.1 Sampling Technique and Sample Size 10.5.2 Study Population 10.5.3 Study Area 10.5.4 Ethical Considerations 10.6 Research Findings and Discussions 10.6.1 Socio-demographic Characteristics of Respondents 10.6.2 Knowledge of What Constitutes Informed Consent 10.6.3 Nature of Information Given at Fertility Clinics 10.6.4 Procedure for Obtaining Informed Consent 10.6.5 Information on the Risks and Benefits of ART Procedure 10.7 Conclusion Bibliography 11 Contract for Gestational Services: Examining the Legal Status and Enforceability of Surrogacy Arrangements in Nigeria 11.1 Introduction 11.2 Status of a Surrogacy Contract 11.3 Illegality, Public Policy and Surrogacy Contracts 11.3.1 Illegality and Surrogacy Contracts 11.3.2 Public Policy and Surrogacy Contracts 11.4 Bases of Enforceability of Gestational Surrogacy Contracts 11.4.1 Genetics as a Basis of Enforcement 11.4.2 Best Interest of the Child as a Basis of Enforceability 11.4.3 Estoppel/Intent/Conduct as a Basis of Enforcement 11.5 Conclusion Bibliography 12 The Role of Data Collection in Developing Adequate Legal Mechanisms for the Practice of Assisted Reproductive Technologies in Sub-Saharan Africa 12.1 Part One 12.1.1 Introduction 12.2 Part Two 12.2.1 Background 12.2.2 Health Records 12.2.3 Healthcare Research Methods 12.2.4 ART Surveillance from a Public Health Surveillance Perspective 12.2.5 Data Collection Approaches 12.2.6 Types of Data Registries 12.2.7 Review of Specific ART Data Collection Registries 12.2.7.1 United States of America 12.2.7.2 Europe 12.2.7.3 Canada 12.2.7.4 Africa 12.2.8 A Global Registry—International Committee for Monitoring Assisted Reproductive Technology 12.2.9 Overview of Approaches to Data Collection 12.3 Part Three 12.3.1 ART Importance of Data Collection 12.3.2 Benefits and Limitations of ART Data Registries: Important Considerations in a Regulatory Framework 12.3.2.1 Benefits of ART Data Collection 12.3.2.2 Limitations 12.4 Part Four 12.4.1 Influence of ART Data Collection in Regulatory Development 12.4.2 How Can ART Data Be Incorporated into a Regulatory Framework to Influence the Development of Appropriate Legal Mechanisms in Nigeria? 12.5 Part Five 12.5.1 Conclusion Bibliography Index