Transcript No Slide Title

Public Education and Advocacy
Against Unsafe Abortion
Anand Tamang
CREHPA
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
ISSUES CONCERNING ABORTIONS

Nepal has one of the highest maternal mortality (539
per 100,000 live births).
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Over half of the maternal deaths are due to unsafe
abortions.
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Induced abortion is a criminal act in any
circumstances, even in case of rape or incest.

Both women and service providers are punishable
by imprisonment
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
ISSUES CONCERNING ABORTIONS (Contd…)
 Despite legal restrictions, every year thousands of
induced abortions are performed illegally.
 Nepal is the probably the only country in the world
where women are incarcerated for abortion
 Prevention and Management of complications of
abortions is one of the eight components of National
RH Strategy 1998 of Ministry of Health/Nepal
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
RESEARCH ON ABORTIONS
Between 1991-2000, a number of abortion
related research conducted and their results
disseminated by CREHPA:
1. Determinants of Abortion and Subsequent
Reproductive Behavior Among Women of Three Urban
Districts of Nepal 1991-94 (Tamang, et al , IIDS)
2. Opinion Polls on Abortion Rights for Women. 1996
3. Induced Abortions and Subsequent Reproductive
Behavior among Women in Urban Areas of Nepal,
Nov. 1996 (Published paper)
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
RESEARCH ON ABORTIONS (Contd..)
Factors Behind Women’s Imprisonment in Nepal with
Special Reference to Women Imprisoned for Abortion,
Sept. 1997-98
5. A Study on Implications of Restrictive Abortion Law
on Women's Social Status and Health 1998 (Published
Paper and Advocacy Paper in Nepali)
4.
6.
Knowledge and Perception of Rural Married Women
on Abortions in Seven districts of Nepal. 1999
7.
Perceptions on Safe & Unsafe abortions among
frontline health providers and village opinion leaders
in Eastern Development Region of Nepal. 1999
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
RESEARCH ON ABORTIONS (Contd..)
8.
Management of abortion related complication in
hospitals of Nepal: A Situation Analysis. 2000
9.
Unwanted Pregnancy, Sex Determination Tests and
Abortion Seeking Behavior in Private Clinics of Nepal.
2000
10. Extent of Contraceptive Failure, Unwanted Pregnancy
and Induced Abortions Among Married Couples in
Kathmandu Valley. 2000 (Analysis on Progress)
11. Role of Private Pharmacist in Preventing Pregnancy
related Complication Including Unsafe Abortions. 2000
(Analysis on Progress)
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
KEY ISSUES EMERGED FROM RESEARCH
 The large majority of the women are unaware of the
legal status of abortion
 The 1997 nationwide prison survey reveals that 80
women (20%) as against 14 men were imprisoned
for charges of abortion or infanticide (CREHPA, 2000).
 20% and 60% of all obs & gyne admissions in six
major hospitals are abortion complication cases.
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
KEY ISSUES EMERGED FROM RESEARCH (Contd…)
 Women with abortion complications occupy
hospital beds for about 3 days to over 7 days
and spend on an average Rs. 3,918 for treatment.
 Most women resorting to unsafe abortion
procedures were unaware about the possible
health risks of the act.
 Majority of the government hospitals lack
sufficient manpower, equipment, space, beds,
etc., to deal with abortion related complications.
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
FELT NEEDS
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Advocacy for Legalizing abortion
Education about health implications of Unsafe
abortions
Enhancement of providers' skills and services at
government hospitals to deal with abortion
complications
Discouragement of abortion services by
Unqualified persons
Periodic updates of abortion data
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
STRATEGIES DESIGN & NETWORKING
Planning and strategies development workshop
organized in October 1998 to initiate PUBLIC
EDUCATION AND ADVOCACY PROGRAM (PEAP)
Purpose:

To develop appropriate advocacy messages
and slogan
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To develop logo for PEAP
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To develop non-threatening messages
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To identify the medium for disseminating
advocacy messages
Networking with Ministry of Health (MOH)
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Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
STRATEGIES DESIGN & NETWORKING (Contd…)

To identify and analyze strengths and weakness
of district level NGOs and explore the ways and
means of empowering them under PEAP

To plan appropriate supervision and monitoring
mechanism for PEAP

To prepare suitable strategies for reopening
policy dialogue with law makers at district and
central levels
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
THE FRAMEWORK
PEAP
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
ACTION : Slogans & Text Messages Developed
Appropriate non threatening advocacy messages
and slogans developed in Nepali:
"Do not rely on unqualified Persons
Do not resort to unsafe abortions"
"Unsafe abortions can claim women's lives
Abortion is not a method of family planning"
"Unsafe Abortion may put women's lives at risk".
"Healthy life of mother and child,
Use methods of family planning,
Avoid Unsafe Abortions"
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
ACTION: Medium of Communication &
Dissemination Identified
Communication & Dissemination Media
Printed
- Posters
- Brochures
- Banners
- Policy Briefs
- Advocacy Papers
- Photo story
- Articles
- Advertisement
Community
Press
Electronic
- Press
Conference
- Radio
Program
- Advocacy
workshops
- Journalists
Forum
- Web-site
- Educational
Workshop
- Street Drama
- NGO
Empowerment
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
ADVOCACY STRATEGIES: Media Coverage
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
Target Audience for PEAP
Advocacy
Education
- Parliamentarians
- Women Groups
- Political Parties
- Social Workers
- Policy Makers/
Administrators
- Community Health Providers
- Lawyers
- Women Associations
- Journalists
- NGO/INGOs
- Pharmacists
- Community Leaders
- School Teachers / High
School Students
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
ACTION: MOH Involved From the Start
 Technical advisory committee with
representatives from NHEICC/MOH formed for
IEC development
 Formal launching of the posters and
brochures by representatives from
NHEICC/MOH
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
ACTION & OUTCOMES OF PEAP-I
 More District level NGOs identified and trained
 District level advocacy workshop held by partner NGOs
 Village level PEAP activities launched by partner NGOs
 Demand created for replication of the program
 Formation of Network : SMHEAN (Safe Maternal Health
Education and Advocacy Network)
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
INFLUENCING POLICY
 Acceptance and ownership of the IEC materials
(Posters) on abortions by MOH
 Inclusion of PEAP related strategies in
government's 15 years health plan
 District Health office (MOH) demand orientation
training for TBAs against unsafe abortions
 Formation of seven member committee (with the
inclusion of CREHPA) by MOH for advocacy
towards legalization of abortion (submission of a
separate abortion bill by MOH)
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
LESSONS
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Research is key to influence Opinion & Policy.
Since abortion is highly divisive issue,
sensitization should start from the top.
Wide range of Approaches needed.
Cost-effective yet expensive
Concerned Policy Makers' involvement required
from planning stage
Credibility of the organization
Creativity & Continuity Necessary
Translating Research into Policy Advocacy
Public Education and Advocacy Against Unsafe Abortion
Thank You
University of Southampton
&
John Snow International, UK