This eight-page brief outlines selected findings from a research project on the burden of abortion-related complications and their contributing factors in the Maternity of Castors in Bangui, Central African Republic. The study found a greater severity of abortion-related complications in this facility compared to African hospitals in stable settings and reinforces the need to recognize abortion as a serious health issue among fragile or crisis-affected populations.
The Center for Health, Human Rights and Development (CEHURD), in partnership with Ipas Africa Alliance, held a regional exchange learning webinar on 25 August 2021, hosted by the Africa Coalition for Safe Abortion (ACSA). ACSA is a broad-based coalition of regional health and human rights civil society organizations that are committed to advocate for access to safe and legal abortion services in line with the Maputo Protocol. This one-page fact sheet outlines the discussion and actions taken during the learning exchange.
Sexual and reproductive health care is often neglected or difficult to access during a crisis, and this can in turn drive more people to seek unsafe abortions that risk their health and lives. For these reasons, Ipas Nigeria conducted a study to understand the impact of Nigeria’s COVID-19 lockdowns on access to safe abortion. Overall, study findings show that the lockdowns exacerbated the pandemic’s impact on women’s access to safe abortion services.
Rwanda reformed its abortion law in 2012, but legal barriers and cultural and religious stigma make it nearly impossible for women to get a safe, legal abortion. Women with unplanned or unwanted pregnancies resort to unsafe and illegal abortions—and Rwandan police unjustly harass, arrest, prosecute and imprison hundreds of women and girls on abortion or infanticide-related charges each year. This report, by Ipas and Great Lakes Initiative for Human Rights and Development, shares findings from interviews with women, judges, legal defense lawyers, and police officers, and calls on the Rwandan government to take steps to address this ongoing human rights violation.
An overview of progressive abortion policy changes and trends in Africa, primarily between 2010-2016. It outlines strategies in regional policy work by Ipas and partners and points to examples of positive policy change, such as national law reform, updated standards and guidelines, commitments by policymakers, and the integration of safe abortion into regional strategies and actions plans on sexual and reproductive health and rights.
Ipas Malawi: 2019-2023 Strategic Plan
This brochure provides an overview of Ipas Ghana’s successful approach to working with young people on issues of sexual and reproductive health.
Comprehensive Abortion Care Needs and Opportunities in Francophone West Africa: Situational Assessment Results
This situational assessment, conducted by Ipas in collaboration with international and in-country agencies in March-May 2015, looks at comprehensive abortion care (CAC) needs and opportunities in francophone West Africa. It concludes there are clear and promising opportunities to expand CAC services to the women who need them and are entitled to them by law, despite the cultural, religious and political opposition to CAC that remains strong in some settings. It also offers specific recommendations in support of implementing CAC programs in francophone West Africa.
Determining the accuracy of pregnancy-length dating among women presenting for induced abortions in Ghana
This study sought to determine the proportion of women presenting for an induced abortion in Ghana who could use a gestational wheel to determine if they had reached at least 13 weeks or fewer than 13 weeks of pregnancy accurately.
Accessing medical and surgical first-trimester abortion services: Women’s experiences and costs from an operations research study in KwaZulu-Natal Province, South Africa
This study explored women’s experiences accessing services and estimate costs incurred for first-trimester abortion at four public hospitals in KwaZulu-Natal Province, South Africa. Despite the availability of government assistance for children through South Africa’s “child grant,” the affordability of raising a child was a major concern for women. Although theoretically available free of charge in the public sector, women experienced challenges accessing abortion services and incurred costs which may have been burdensome given average local earnings. These potential barriers could be addressed by reducing the number of required visits and improving availability of pregnancy tests and supplies in public facilities.
Developing a scale to measure stigmatizing attitudes and beliefs about women who have abortions: Results from Ghana and Zambia
The objective of this research was to explore the context of abortion stigma in Ghana and Zambia through qualitative research, and develop a quantitative instrument to measure stigmatizing attitudes and beliefs about abortion. Focus group discussions were conducted in both countries, and a Stigmatizing Attitudes, Beliefs, and Actions scale was created. It captures three important dimensions of abortion stigma: negative stereotypes about men and women who are associated with abortion, discrimination/exclusion of women who have abortions, and fear of contagion as a result of coming into contact with a woman who has had an abortion. It provides a validated tool for measuring stigmatizing attitudes and beliefs about abortion in Ghana and Zambia and has the potential to be applicable in other country settings.
This factsheet shares the results of a national study by the Guttmacher Institute and Ipas, in collaboration with the Ethiopian Society of Obstetricians and Gynecologists and the Ethiopian Public Health Association, and in conjunction with Ethiopia’s Federal Ministry of Health.
Conclusions de l’analyse situationnelle : besoins et opportunités pour une prise en charge des soins complets d’avortement en Afrique de l’Ouest francophone
L’analyse situationnelle, effectuée par Ipas en mars et mai 2015 en collaboration avec des agences internationales et des organisations nationales actives dans ce domaine a permis d’étudier les besoins et les opportunités de prise en charge des soins complets d’avortement en Afrique de l’Ouest francophone et a conclu qu’il existait des possibilités manifestes et prometteuses pour étendre les soins complets d’avortement et les rendre disponibles aux femmes qui les nécessitent et qui y ont droit en vertu de la loi malgré la persistance d’une forte opposition culturelle, religieuse et politique à ce type de soins dans certains secteurs.
This paper estimates the incidence of legal and clandestine abortions and the severity of abortion-related complications among adolescent and nonadolescent women in Ethiopia in 2014. We find no evidence that adolescents are more likely than older women to have clandestine abortions. However, the higher abortion and pregnancy rates among sexually active adolescents suggest that they face barriers in access to and use of contraceptive services. Further work is needed to address the persistence of clandestine abortions among adolescents in a context where safe and legal abortion is available.
Doing more for less: Identifying opportunities to expand public sector access to safe abortion in South Africa through budget impact analysis
The objective of this study was to estimate the costs of public-sector abortion provision in South Africa and to explore the potential for expanding access at reduced cost by changing the mix of technologies used. It concludes that South Africa can provide more safe abortions for less money in the public sector through shifting the methods provided–and says that more research is needed to understand whether the cost of expanding access could be offset by savings from averting costs of managing unsafe abortions.
Improving health worker performance of abortion services: An assessment of post-training support to providers in India, Nepal and Nigeria
This paper reports the results of an intervention with 3,471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period. The intervention also included technical assistance to and upgrades in facilities where the providers worked.
What factors contribute to postabortion contraceptive uptake by young women? A program evaluation in 10 countries in Asia and sub-Saharan Africa
This evaluation assesses the factors that influence contraceptive uptake among adolescents and young women seeking abortion care in health facilities. We analyzed client log book data from 921,918 abortion care cases in 4,881 health facilities in 10 countries from July 2011 through June 2015, and found that programmatic support to health systems, including provider training in contraceptive counseling and provision, was associated with women’s higher acceptance of postabortion contraception.
…[N]umerous instances have been reported where women have been denied termination of pregnancy services for pregnancies arising out of rape, incest and sexual violence. There is also the rising issue of women and girls being forced by the police to keep the pregnancy in cases of incest or rape to preserve the infant to be used to retrieve DNA for evidence while prosecuting the perpetrator.
During last year’s national exams, media reported alarming cases of girls who sat the papers in delivery rooms or went into labour in the exam room.These statistics show the need for urgent action and awareness to enable the youth to manage their own sexual and reproductive health. Estimates from developing countries indicate that pregnancy and delivery complications, including unsafe abortions, are the second leading causes of death for girls below 20 years.