June 2018 News Review

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Debates over Sex Education and Abortion Rights

Education is the first step in providing women and girls (and men and boys) with adequate tools to manage reproductive choice. Debate about how much sex education to provide and when took place in many African countries in June. A conference in Angola launched a new sex ed campaign, while in South Africa the government has gotten resistance from some parents who say it promotes promiscuity. The Ugandan education ministry is rolling out a sexuality education framework, but is confronting rejection from church leaders and some district governments which say it will “ruin children’s lives.” Zimbabwean First Lady Amai Auxillia Mnangagwa participated in training on reproductive health, calling for more information for the most marginalized communities. Rwandan parents have been “urged to talk to their children about reproductive health.” And in Namibia, educators are struggling with its policy of how to deal with pregnant pupils.

Increasing contraception access is another factor, as Sierra Leone launched a free contraception service, a Zimbabwean plan to distribute condoms in prison raised “moral” concerns, a study in Rwanda showed promise for increased use of the contraceptive vaginal ring, and a University of Georgia study in Uganda found that despite a desire by women to use long-acting reversible contraceptives (LARCs), their use was hindered by cultural norms and economic barriers created by husbands. PRB published an excellent strategic guide which shows how expanding the choice of methods greatly enhances FP program success.

Even with more sex education and access to contraception, the need for access to safe abortion services is a vital element of sexual and reproductive rights – and in many countries in Africa is under threat. One response to the “conscientious objection” by medical professionals in South Africa who deny women their legal right to choose is to increase referrals to centers and providers that can serve them, with government action to map service availability.

The South African situation shows that merely having pro-choice laws does not guarantee the end of deaths from unsafe abortion. A report from Tunisia shows that even though it has been legal in the country since 1973, abortion remains taboo. In Tanzania, unsafe abortion is “the silent killer”, accounting for 16% of maternal deaths. Burkina Faso has a problem with delays in dealing with rape cases, denying victims legal and safe abortion. Activists in Senegal say the country’s restrictive abortion laws lead women to “infanticide and prison”. Despite the ban on private use of abortion pills in Nigeria and Ghana, those countries top the list of countries where citizens search Google for Misoprostol.

Around the world, changes to abortion rights legislation are being promoted and considered in Colombia, Venezuela, Philippines, Argentina (where current law can lead to a four-year prison sentence for having an abortion), Gibraltar, Jamaica, Belgium, Brazil, Mexico and South Korea. A sobering statistic: 6% of the world’s 1.64 billion women of reproductive age live in a country where abortion is illegal, with no exceptions.

US Anti-Choice Momentum and its Consequences

While a major USAID Family Planning program is coming to an end in Togo, Kenya’s largest reproductive health organization is shutting clinics as it has lost $2.2 million is US funding because of the Global Gag Rule. It’s a US policy that is “trapping women in poverty, and the world is watching.” The effects of the policy include a threat to advances made in fighting AIDS and STDs, and ultimately could “cause millions more abortions by 2020.” A study by the Center for Health and Gender Equity (CHANGE) looks at the broad spectrum of harmful effects the policy is having. “Young women, children, and LGBTQ individuals, in rural communities especially, are particularly hard-hit by the expansion.”

In the US, a series of anti-choice decisions by the Supreme Court, as well as the announcement of the retirement of Justice Anthony Kennedy, has thrown access to abortion and even contraception into question, leading some women to wonder if they should rush out and get an IUD. The threat to the landmark Roe v. Wade case which legalized abortion is real with the nomination of an anti-choice justice, despite the fact that Two-thirds of Americans Don’t Want the Supreme Court to Overturn Roe v. Wade. One ruling allowing “crisis pregnancy centers” to keep information about abortion away from patients provides “a green light for more crisis pregnancy centers to open up across the country and for current ones to continue their deceptive practices,” according to Justine Wu, an assistant professor at the University of Michigan and board member of the Association of Reproductive Health Professionals.

A study published in the Journal of the American Medical Association “unequivocally shows that restricting abortions to one type of facility makes no public health sense.” And banning abortion “does not make it go away,” as an article states with a reference to the first recorded mention of the practice in 1550 BC.

The battle could move to each state: 24 states could ban abortion within two years of a Supreme Court rescission of Roe v. Wade.

Research Highlights

CIRHT research Structured integration of family planning curriculum: comparative assessment of knowledge and skills among new medical graduates in Ethiopia is published in the August edition of the journal Contraception. The conclusion: “A structured integration of family planning curriculum was associated with higher scores in knowledge, clinical skills and self-assessed competencies. Integrating comprehensive family planning training in medical curriculum can lead to graduating physicians who are more competent to offer the full range of FP options.”

Several other studies about Ethiopia also came out – about Contraceptive use and method preference among HIV-positive women in the Amhara region, Socioeconomic and religious differentials in contraceptive uptake in western Ethiopia, Family planning utilization and factors associated among women receiving abortion services in health facilities of central zone towns of Tigray, Northern Ethiopia, and Professional Pragmatism and Abortion Stigma: Assessing the Performance of the Stigmatizing Attitudes, Beliefs and Actions Scale (SABAS) among Ethiopian Midwives.

IPAS produced two useful toolkits: Abortion Attitude Transformation: A values clarification toolkit for humanitarian audiences and Roots of Change: A step-by-step advocacy guide for expanding access to safe abortion. The International Women’s Health Coalition released a timely Policy Recommendations to Prevent Denial of Abortion Care.

Complete References

Angola

Le secteur se lance aux actions d’éducation sexuelle, ANGOP, 21 Jun 2018

NGOs’ commitment to convey educational messages highlighted, ANGOP, 12 Jun 2018

Burkina Faso

Mariam Nonguerma/Zorome, presidente de l’association burkinabe des sages-femmes « La durée des enquêtes empêche souvent les filles violées de bénéficier de l’avortement légal et sécurisé», Le Pays, 6 Jun 2018

Burundi

Insight Into Maternal Health in Humanitarian Crisis Settings, MHTF, 20 Jun 2018

Egypt

‘Two are enough’: Gov’t bid to control increasing population, Egypt Today, 23 Jun 2018