Public Education and Advocacy Against Unsafe Abortion Anand Tamang CREHPA.
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Transcript of Public Education and Advocacy Against Unsafe Abortion Anand Tamang CREHPA.
Public Education and Advocacy
Against Unsafe Abortion
Anand Tamang
CREHPA
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
Nepal has one of the highest maternal mortality (539 per 100,000 live births).
Over half of the maternal deaths are due to unsafe abortions.
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
ISSUES CONCERNING ABORTIONS
Translating Research into Policy AdvocacyPublic 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 AdvocacyPublic Education and Advocacy Against Unsafe Abortion
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)
RESEARCH ON ABORTIONSBetween 1991-2000, a number of abortion related research conducted and their results disseminated by CREHPA:
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
4. 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)
6. Knowledge and Perception of Rural Married Women on Abortions in Seven districts of Nepal. 1999
7.7. Perceptions on Safe & Unsafe abortions among frontline Perceptions on Safe & Unsafe abortions among frontline health providers and village opinion leaders in Eastern health providers and village opinion leaders in Eastern Development Region of Nepal. 1999Development Region of Nepal. 1999
RESEARCH ON ABORTIONS (Contd..)
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
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)
RESEARCH ON ABORTIONS (Contd..)
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
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.
KEY ISSUES EMERGED FROM RESEARCH
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
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.
KEY ISSUES EMERGED FROM RESEARCH (Contd…)
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
FELT NEEDS
Advocacy for Legalizing abortion Advocacy for Legalizing abortion Education about health implications of Unsafe Education about health implications of Unsafe
abortionsabortions Enhancement of providers' skills and services at Enhancement of providers' skills and services at
government hospitals to deal with abortion government hospitals to deal with abortion complicationscomplications
Discouragement of abortion services by Discouragement of abortion services by
Unqualified personsUnqualified persons Periodic updates of abortion dataPeriodic updates of abortion data
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
Planning and strategies development workshop Planning and strategies development workshop organized in October 1998 to initiate organized in October 1998 to initiate PUBLIC PUBLIC EDUCATION AND ADVOCACY PROGRAMEDUCATION AND ADVOCACY PROGRAM (PEAP) (PEAP)
Purpose:Purpose:
STRATEGIES DESIGN & NETWORKING
To develop appropriate advocacy messages and slogan
To develop logo for PEAP
To develop non-threatening messages
To identify the medium for disseminating advocacy messages
Networking with Ministry of Health (MOH)
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
To identify and analyze strengths and weakness To identify and analyze strengths and weakness of district level NGOs and explore the ways and of district level NGOs and explore the ways and means of empowering them under PEAPmeans of empowering them under PEAP
To plan appropriate supervision and monitoring To plan appropriate supervision and monitoring mechanism for PEAPmechanism for PEAP
To prepare suitable strategies for reopening To prepare suitable strategies for reopening policy dialogue with law makers at district and policy dialogue with law makers at district and central levelscentral levels
STRATEGIES DESIGN & NETWORKING (Contd…)
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
ActionEvaluation
Situation Analysis Strategies
Mobilization
Continuity/
Expansion
PEAP
THE FRAMEWORK
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
"Do not rely on unqualified Persons "Do not rely on unqualified Persons Do not resort to unsafe abortions"Do not resort to unsafe abortions"
"Unsafe abortions can claim women's lives"Unsafe abortions can claim women's livesAbortion is not a method of family planning"Abortion is not a method of family planning"
"Unsafe Abortion may put women's lives at risk"."Unsafe Abortion may put women's lives at risk".
"Healthy life of mother and child, "Healthy life of mother and child, Use methods of family planning,Use methods of family planning,Avoid Unsafe Abortions"Avoid Unsafe Abortions"
ACTION : Slogans & Text Messages Developed Appropriate non threatening advocacy messages and slogans developed in Nepali:
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
ACTION: Medium of Communication & Dissemination Identified
Printed
Communication & Dissemination Media
Press Electronic Community
- Posters
- Brochures
- Banners
- Policy Briefs- Advocacy Papers - Photo story- Articles- Advertisement
- Press Conference
- Journalists Forum
- Radio Program
- Web-site
- Advocacy workshops
- Educational Workshop
- Street Drama
- NGO Empowerment
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
ADVOCACY STRATEGIES: Media Coverage
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
Target Audience for PEAP
Advocacy
- Parliamentarians
- Political Parties
- Policy Makers/ Administrators
- Lawyers
- Women Associations
- Journalists
- NGO/INGOs
Education
- Women Groups
- Social Workers
- Community Health Providers
- Pharmacists
- Community Leaders
- School Teachers / High School Students
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
Technical advisory committee with representatives from NHEICC/MOH formed for IEC development
Formal launching of the posters and brochures by representatives from NHEICC/MOH
ACTION: MOH Involved From the Start
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
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)
ACTION & OUTCOMES OF PEAP-I
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
INFLUENCING POLICY 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 AdvocacyPublic Education and Advocacy Against Unsafe Abortion
LESSONS ResearchResearch is key to influence Opinion & Policy. is key to influence Opinion & Policy. Since abortion is highly divisive issue, Since abortion is highly divisive issue,
sensitizationsensitization should start from the top. should start from the top. Wide range of Wide range of Approaches Approaches needed. needed. Cost-effective Cost-effective yet expensiveyet expensive Concerned Concerned Policy Makers' involvementPolicy Makers' involvement required required
from planning stagefrom planning stage
CredibilityCredibility of the organization of the organization CreativityCreativity & & ContinuityContinuity Necessary Necessary
Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion
Thank YouUniversity of Southampton
&John Snow International, UK