Evidence map›Paper›PMID 41993758›Full record

ReviewFrontiers in reproductive health2026

Abortion in conflict zones: moral responsibilities of humanitarian agencies in providing safe abortion care.

Collins Chibueze Anokwuru, Onyeka Chukwudalu Ekwebene, Moses Ifeatu Nwuzoh, Gabriel Chidera Edeh, Chioma Adaora Nwalieji, Ephraim Ikpongifono Udokang, Chidera Gabriel Obi, Stanley Eneh

Abstract readReview
In one paragraph

Review in Frontiers in reproductive health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Collins Chibueze AnokwuruDepartment of Public Health, Federal University of Technology Owerri, Owerri, Nigeria.
Onyeka Chukwudalu EkwebeneDepartment of Pediatrics, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, United States.
Moses Ifeatu NwuzohInstitute of Social Sciences, Sheffield Hallam University, Sheffield, United Kingdom.
Gabriel Chidera EdehDepartment of Haematology/Blood Transfusion, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria.
Chioma Adaora NwaliejiFaculty of Clinical Sciences, University of Nigeria Teaching Hospital Enugu State, Enugu, Nigeria.
Ephraim Ikpongifono UdokangFaculty of Pharmacy, University of Uyo, Uyo, Akwa Ibom State, Nigeria.
Chidera Gabriel ObiDepartment of Parasitology and Entomology, Nnamdi Azikiwe University Awka, Awka, Nigeria.
Stanley EnehDepartment of Community Health, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Unsafe abortion remains a leading cause of maternal mortality globally, disproportionately affecting women in conflict zones where health systems are fractured, legal protections are weakened, and access to reproductive care is severely limited. Armed conflict increases the incidence of unwanted pregnancy through sexual violence, displacement, and disruption of contraceptive services, while also heightening barriers to timely, comprehensive abortion care. Despite growing international recognition of abortion as a life-saving intervention, humanitarian agencies often face legal, cultural, and operational barriers that hinder service provision. From an ethical standpoint, obligations grounded in humanity, beneficence, respect for autonomy, impartiality, and the right to health support the inclusion of safe abortion as an essential, reproductive health service. International practice shows that agencies can deliver services through adaptable modalities such as mobile clinics, trained local providers, telemedicine guidance, and integration of the minimum initial service package at onset of crises; but legal variability and criminalization complicate implementation and expose both patients and providers to risk. Operational challenges include disrupted supply chains for medical abortion drugs and equipment, workforce shortages and ethical tensions among staff, monitoring and accountability constraints, and community resistance shaped by cultural and religious norms. The analysis highlights pragmatic strategies that preserve rights while navigating constraints: prioritizing clinical training and values-based preparation for personnel, ensuring availability of evidence-based supplies, embedding timely abortion care within emergency service packages, engaging communities to reduce stigma, and strengthening monitoring systems to protect patients and providers. Safe abortion services in humanitarian settings are not optional adjuncts but moral imperatives. Humanitarian agencies must move beyond rhetorical support to operationalize rights-centred, evidence-based abortion care despite legal and logistical challenges. Upholding reproductive dignity and preventing avoidable harm in conflict zones requires decisive action: sustained commitment to service delivery, workforce capacity, supply security, community engagement, and accountability mechanisms that together translate ethical obligation into lifesaving practice.

Indexed as

abortion servicesconflict zoneshealthhuman rightmoral ethicswar

Identifiers

PMID41993758
PMCPMC13079646

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.