Global Health

Carlos Moreno

Fulbright Visiting Professor

Carlos Moreno-Jaimes has been a visiting researcher at the Center for US-Mexican Studies at the University of California, San Diego and at the Public Policy and Government Institute at the Universidad de Guadalajara. In the late nineties, he worked as an associate professor at CIDE (Centro de Investigación y Docencia Económicas), where he was also appointed Director of the Master Program in Public Policy and Administration. He specializes in heath-care policy, public spending decentralization and local governance in Mexico, with a particular emphasis on performance evaluation. Carlos has been a consultant for several international agencies such as The World Bank, the Inter-American Development Bank (IADB), the United Nations Development Program (UNDP), and many other public institutions in Mexico. Since 2005, Carlos is full-time research-professor at ITESO, in Guadalajara.

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UT health policy expert and pediatrician Dr. Michael Hole joins Council on Foreign Relations

July 1, 2021
Michael Hole, founder and executive director of The Impact Factory at The University

Self reported outcomes and adverse events after medical abortion through online telemedicine: population based study in the Republic of Ireland and Northern Ireland

Article, Refereed Journal
Objectives: To assess self reported outcomes and adverse events after self sourced medical abortion through online telemedicine. Design: Population based study. Setting: Republic of Ireland and Northern Ireland, where abortion is unavailable through the formal healthcare system except in a few restricted circumstances. Population: 1000 women who underwent self sourced medical abortion through Women on Web (WoW), an online telemedicine service, between 1 January 2010 and 31 December 2012. Main outcome measures: Successful medical abortion: the proportion of women who reported ending their pregnancy without surgical intervention. Rates of adverse events: the proportion who reported treatment for adverse events, including receipt of antibiotics and blood transfusion, and deaths reported by family members, friends, or the authorities. Care seeking for symptoms of potential complications: the frequency with which women reported experiencing symptoms of a potentially serious complication and the proportion who reported seeking medical attention as advised. Results: In 2010-12, abortion medications (mifepristone and misoprostol) were sent to 1636 women and follow-up information was obtained for 1158 (71%). Among these, 1023 women confirmed use of the medications, and follow-up information was available for 1000. At the time women requested help from WoW, 781 (78%) were <7 weeks pregnant and 219 (22%) were 7-9 weeks pregnant. Overall, 94.7% (95% confidence interval 93.1% to 96.0%) reported successfully ending their pregnancy without surgical intervention. Seven women (0.7%, 0.3% to 1.5%) reported receiving a blood transfusion, and 26 (2.6%, 1.7% to 3.8%) reported receiving antibiotics (route of administration (IV or oral) could not be determined). No deaths resulting from the intervention were reported by family, friends, the authorities, or the media. Ninety three women (9.3%, 7.6% to 11.3%) reported experiencing any symptom for which they were advised to seek medical advice, and, of these, 87 (95%, 87.8% to 98.2%) sought attention. None of the five women who did not seek medical attention reported experiencing an adverse outcome. Conclusions: Self sourced medical abortion using online telemedicine can be highly effective, and outcomes compare favourably with in clinic protocols. Reported rates of adverse events are low. Women are able to self identify the symptoms of potentially serious complications, and most report seeking medical attention when advised. Results have important implications for women worldwide living in areas where access to abortion is restricted.
Research Topic
Global Health
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