Although abortion is legal in Zambia, the barriers to accessing safe abortion care are formidable. Doctors are in short supply, and there is a strong and persistent social stigma surrounding abortion. Very few women know they have the right to a safe, legal abortion or know where to seek safe abortion services; as a result, unsafe abortion is a major problem in Zambia. The Zambian Ministry of Health estimates that as many as 30% of pregnancy-related deaths may be caused by unsafe abortion, and hospital-based studies show that 30-50% of acute gynecological admissions are caused by complications from unsafe abortion.
Ipas has worked in Zambia since 2006, focusing on the broad goal of reducing abortion-related deaths and injuries. After an initial strategic assessment on abortion care and a multi-year study to introduce medical abortion (abortion with pills) in to Zambia’s public health facilities, Ipas has worked in partnership with government agencies to extend safe abortion services across the country. Ipas works with the Ministry of Health and other partners to improve women’s and girls’ access to safe abortion and contraceptive services, to train providers and pharmacists, to equip health-care facilities, and to mobilize youth and community partners to raise awareness about reproductive health and rights.
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‘You have to get through the shell and the crown’
As part of a “photovoice” project, Kuza Kamanga, of Ipas Zambia, was asked to take a photo portraying the barriers and challenges that women face in accessing safe abortion care. He decided that a pineapple was the perfect symbol: to get to the fruit, you have to get through the shell and the crown—which represent such obstacles as abortion stigma and restrictive laws. He explains his thinking in this video.