Keeping the promise: Ipas Ghana’s 14 years of action to expand safe abortion care
The availability of safe abortion care in Ghana was more of a promise than a reality when Ipas Ghana launched its national program in 2006. A fairly liberal abortion law had been enacted in 1985. But in 2005, when the Ghana Health Service did a strategic assessment of comprehensive abortion care, the findings were grim: “crude and dangerous” abortion methods were common, religious opposition to abortion was deeply rooted, and the public still had little or no understanding that abortion was legal.
Against that backdrop, Ipas Ghana began its work to reduce deaths and injuries from unsafe abortion and to make a full range of reproductive health services available to women and girls. In the years since, Ipas Ghana has made major gains in increasing women’s and girls’ access to safe abortion care and contraception, and has been a key player in the R3M (Reducing Maternal Mortality and Morbidity) partnership.
In the last nine years, Ipas Ghana has trained nearly 7,000 health providers on comprehensive abortion care, provided support at more than 300 public health facilities, and helped to develop national standards and guidelines on abortion care. During that time, more than 195,000 abortion services have been provided at Ipas-supported health facilities.
Innovative projects that serve as models for other countries have also been a hallmark of Ipas Ghana’s work, including:
- Training of police officers, judges and magistrates on the abortion law and the right of women to access services;
- Mainstreaming of the youth perspective by establishing a Youth Advisory Board and integrating its inputs into programs;
- Initiating school-based comprehensive sexuality education by training and supporting school counsellors to provide accurate sexual and reproductive health information to students and connect them to services;
- Partnering with and training community health nurses, pharmacists, medicine sellers and Queen Mothers (who are revered traditional rulers) to disseminate sexual and reproductive health and rights messages in communities and to link individuals to services;
- Organizing a landmark regional conference on unsafe abortion in 2010, which brought together government leaders, health-care providers, youth advocates and others from more than 20 African nations, and accelerated action to expand access to safe abortions.
“Efforts such as these have helped make the promise of Ghana’s abortion law a reality,” says Dr. Koma S. Jehu-Appiah, who has served as country director for Ipas Ghana. “It has translated into more services for more women. We are proud of Ipas’s role in making this progress—and we remain committed to supporting partners in Ghana to sustain it.”
After 14 years, with the abortion landscape in Ghana improving and funding priorities of institutional donors shifting, Ipas Ghana is closing its program. The Ghana Health Service will be taking on more of the work of expanding safe abortion care in the country.
“In all of our country programs, we strive to ensure that abortion care is sustainable,” says Ipas President and CEO Anu Kumar. “We aim for eventual health system ownership of comprehensive abortion care, with the guiding goal that all women and girls who want and need such care have safe and affordable access.”
Looking back on Ipas Ghana’s early years, Kumar says its work was crucial. “Even though an abortion law was on the books, no one had implemented it. In collaboration with the government and other partners, Ipas Ghana finally helped get the law implemented. And they were able to do it despite the tremendous levels of conservatism and abortion stigma in the country.”
The stories and photos below capture just some of the highlights of Ipas Ghana’s work throughout the years—work that has laid the foundation for continued safe abortion care in Ghana.
Breaking the cultural silence around abortion
One Sunday after church, I returned to the hospital where I was working as medical doctor. At the gate, I saw a woman with her young daughter. Both were crying. The daughter had gotten pregnant as the result of sexual abuse and was seeking abortion care. They had sought services nearer their home, which was three hours away, but had been turned away for various reasons. Now they were at the gate of my hospital and didn’t know where to go or what to do.
I proceeded to take a detailed history, and provided counseling and safe abortion services since I was a trained service provider. It was an emotional experience, and made me understand that so many other people are in her situation and need abortion access and quality services. A year or two later, I joined the Ipas Ghana staff and am proud to now be part of the global movement for reproductive health and rights. In Ghana, we’re working hard to break the cultural silence around the subject of abortion, because reproductive health care, including safe abortion, is a fundamental human right.
– Dr. Pius Ato Essandoh, national program manager, Ipas Ghana