Sub-Saharan Africa

 
 
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REgional - Mobilizing Activists around Medical Abortion in Sub-Saharan Africa (MAMA Network)

The Mobilizing Activists around Medical Abortion in Sub-Saharan Africa (MAMA Network) was founded in 2016 as a regional network aimed at strengthening collaborative relationships between groups of grassroots activists working to expand access to medical abortion in the region. 

Under this SAAF supported project the MAMA network will work collaboratively with Women Help Women and Ibis Reproductive Health to run a research study aimed at expanding the evidence base on safe self-use of medical abortion by documenting attitudes, decision-making and effectiveness in Sub-Saharan Africa. It will also build the capacity of MAMA Network members to ensure standardized and systematic data collection, analysis, and dissemination within the Network, as well as both regionally and globally. By doing so, the aim is that members will be able to compare impact between countries and contexts, identify best practices, modify and improve their approaches, and strengthen the evidence for shared strategies to increase access to safe abortion through community activism.


Burkina Faso - Communauté d’Action pour la Promotion de la Santé Sexuelle et Reproductive au Burkina Faso (CAPSSR-BF)

Abortion in Burkina Faso is legal if the abortion will save the woman's life, the pregnancy gravely endangers the woman's physical or mental health, the child will potentially be born with an incurable disease, or in cases where the pregnancy is a result of rape or incest, however only if it is proven by a state prosecutor. Even these abortions are limited to the first ten weeks of pregnancy and legal abortion is impossible for most women to access.

The national coalition Communauté d’Action pour la Promotion de la Santé Sexuelle et Reproductive au Burkina Faso (CAPSSR-BF) is campaigning to improve the law to allow abortion under more grounds. They intend to work directly with community, religious and customary leaders to encourage them to recognise the need for legal and policy change to ensure more women can access safe legal abortion care, as these leaders will prove strong champions for legal and cultural change. They also plan to build the legal capacity of health professionals on the management of current abortion cases and of police officers for the handling of legal cases related to aborton that fall within the current law so that more women are able to realise their rights to sexual and reproductive care, thereby reducing unsafe abortions and related complications.

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BURUNDI - RÉSEAU SOS FEMMES EN DÉTRESSE (SOSFED)

In Burundi, unsafe abortion is one of the leading causes of death and disability among women and girls. Post-abortion care services, when available, are almost exclusively clustered in the Burundian capital and other major urban centers. The further away from these urban centers, the lower the number of skilled  providers.

SOS FED tackles this challenge by working with six health facilities across Burundi to enable the provision of quality post-abortion care and contraceptive services. SOS FED also tackles the phenomenon of abortion stigma and its consequences through the dissemination of accurate information and promotion of positive attitudes.


DR CONGO - COMITÉ D’ECHANGE ET D’INFORMATION SUR LA FEMME ET POUR LE DÉVELOPPEMENT (CEIFD)

CEIFD works in South Kivu, in the East of the DR Congo. South Kivu is a conflict zone with high incidence of sexual violence and limited availability of reproductive health services.

CEIFD provides support via training and supervision to 20 health facilities, to ensure the availability of safe post-abortion care and contraceptive services. It also conducts awareness raising sessions with local decision makers and the wide community, with a view of reducing abortion related stigma.

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DR CONGO - GROUPEMENT DES FEMMES VIVANT AVEC LE VIH (GFV)

GFV-VIH is working in the eastern DR Congo province of South Kivu. The project’s main goal is to ensure that women and girls have access to safe post-abortion care and harm reduction services.

They use multiple strategies, such as strengthening the capacity of structures to provide quality services and engaging the local community to inform, educate and raise awareness on sexual reproductive health issues, with a particular aim of addressing the stigma surrounding abortion.


DR CONGO - THIS ORGANISATION HAS ASKED TO REMAIN ANONYMOUS

The organisation is working in the eastern DR Congo province of South Kivu, with a goal of ensuring that women and girls have access to safe post-abortion care and harm reduction services.

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DR CONGO - SI JEUNESSE SAVAIT (SJS)

Abortion was illegal under nearly all circumstances in the Democratic Republic of Congo (DRC) despite the country being signatory of the Mputo protocol and the countries’ constitution stating that international treaties ratified by the government shall supersede national laws. However, as of 2018, abortion was legalised under many more circumstances with the Maputo Protocol being published in the national legal gazette. Due to years of illegal abortion and lack of knowledge about the new law however, unsafe abortion remains a large cause of illness and death. 

Si Jeunesse Savait (SJS) focuses on supporting young people in the capital Kinshasa. They have been providing harm reduction information to young people and campaigning to change the law for a number of years. Under this SAAF supported project they will increase their work with communities, highlighting the dangers of unsafe abortions and the need to access safe care, improve referral to youth friendly abortion care facilities and share best practice within the sector on how to improve programming to support adolescent girls.


Ethiopia - THIS ORGANISATION HAS ASKED TO REMAIN ANONYMOUS

The maternal mortality rate in Ethiopia is extremely high and 32% of this is caused by unsafe abortion. Despite abortion laws having been relaxed in 2005, safe abortion is still hard to access for women especially for girls and young women in remote areas. 

This SAAF funded project hopes to change this by working with young people and communities in the North-western states of Amhara and Benishangul-Gumuz to increase awareness and public support for abortion while also improving the quality of care provided. This will hopefully lead to young people in the regions having accesses to quality safe abortion care, without stigma or discrimination therefore preventing abortion-related death and disabilities.

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GHANA - Ghana National Association of the Deaf (GNAD)

Despite relatively liberal abortion laws in Ghana; stigma, high costs, lack of information and knowledge all mean that unsafe abortion is a major cause of maternal deaths and pregnancy related complications in the country. Although there is a lack of data on the specific issues faced by deaf women and girls, it is clear that they are especially vulnerable to sexual abuse, unwanted pregnancy and unsafe abortion as they often lack access to information and care. 

The Ghana National Association of the Deaf (GNAD)’s vision is to achieve an active and productive deaf community with access to education, information, and steady economic activities that can sustain and maintain quality and security of life. Its SAAF project is aimed at increasing the evidence base on the abortion needs and practises of deaf women and girls in the country in order to inform national policies. To work directly with health providers and the deaf community to improve deaf women and girl’s access to safe clinical abortion care in six districts and to adovcate to the ministry of health to ensure that deaf women’s specific needs are included in public SRHR service provision.


GHANA - MABIA GHANA

Unsafe abortion contributes significantly to a high maternal mortality in Ghana, particularly in the three northern regions. Although the abortion law of Ghana is relatively liberal, safe abortion services are non-existent in some districts, knowledge of the abortion law is low and stigma is high. 

Through this project, MABIA-Ghana will work in two under-served districts of Northern Ghana in the Upper East and Northern regions. The project will aim to increase knowledge of legal rights to abortion among school students and introduce quality, non-judgemental, comprehensive abortion care to women and girls in public health facilities, at the same time ensuring that two midwifery training colleges are able to provide quality pre-service training on safe abortion to trainee midwives.


Kenya - THIS ORGANISATION HAS ASKED TO REMAIN ANONYMOUS

In the Nairobi slums, high levels of sexual violence and abuse, lack of knowledge about, or access to, contraception and high levels of poverty and inequality mean that unwanted pregnancy is a common experience among girls and young women. Safe and legal abortion is hard to access, putting women at risk of injury and death from unsafe abortion.

By working with young women and men in the Dandora slum, the organisation aims to empower the women to claim their rights, increase their knowledge of reproductive and sexual health and reduce abortion stigma, while also preventing the harm caused by informal health providers by giving them relevant training and safe referral points.

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KENYA - TRUST FOR INDIGENOUS CULTURE AND HEALTH (TICAH)

TICAH’s aim is to promote health. Their focus is on good relationships, healthy households, and community action. This project plans to make reproductive choice and safe abortion understood and accessible to a wider range of Kenyan women and girls especially young, underserved and vulnerable women.

Working with women and girls in Nairobi, Eastern and Coastal province, TICAH aims to improve their knowledge, agency and ability to make choices on contraception and safe abortion. Part of the project will also be to strengthen the Aunty Jane hotline that people call from across Kenya to get information on sexual and reproductive health issues.  


Malawi - The centre for solutions journalism (CSJNEWS)

The Centre for Solutions Journalism based in Blantyre, Malawi is an NGO founded by media specialists that focuses on professional dissemination of news and best practices that offer solutions to social, economic and development challenges facings Malawians. CSJNEWS has been working on issues of abortion in the past two years implementing projects as a sub grantee of the Coalition for Prevention of Unsafe Abortion (COPUA) in Malawi.  

The SAAF supported project is focused on advocating for the enactment of the Termination of Pregnancy Bill in Malawi which would legalise abortion under a number of circumstances. The project will build the capacity of women's groups to advocate for abortion law reform as well as lobbying MPs directly to get their support. The key activities of the project will be lobbying (engagement with lawmakers), capacity building (training of rural women advocates) and production and broadcasting of an abortion law reform radio programme and jingles.


MALAWI - RIGHTS INSTITUTE FOR SOCIAL EMPOWERMENT (RISE)

In Malawi, abortion is legal only if performed to save a woman’s life. As a result, most induced abortions are performed under unsafe conditions. This contributes to a high maternal mortality rate. 

RISE's project will contribute to the current abortion legalization debate, drafting new and progressive abortion laws and advocate for draft bills to be tabled in parliament and passed into law. The main components are advocacy, capacity building, community education and creating effective partnerships for sexual and reproductive heath care. Expected outcomes include improved laws and policies governing abortion, increased awareness of, and support for, safe abortion, increased access to safe abortion services and reduced maternal deaths resulting from unsafe abortions.


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NIGERIA - WOMEN FRIENDLY INITIATIVE (WFI)

In Nigeria, 13% of maternal deaths are attributable to unsafe abortions and an estimated 1 in 12 women have undergone an unsafe abortion. Having run a SAAF funded project since 2014, WFI has adopted an innovative public-private facility cluster model which built the capacity of midwives from government-funded midwifery service scheme for post-abortion care as part of comprehensive sexual health services. Male advocates and local media troupes were trained and communities were mobilized to reduce barriers to service access. 

In the current phase, WFI is building the capacity of a new cohort of providers and training youth peer provider to mobilize youth across the Federal Capital Territory. This will expand and sustain access to post-abortion care, safe abortion and post-procedure contraception to reduce maternal mortality and morbidity resulting from unwanted pregnancy, unsafe abortion and its complications.


NIGERIA - INTERNATIONAL CENTRE FOR POVERTY ALLEVIATION AND SUSTAINABLE DEVELOPMENT (CENPAD)

Women and girls living in the Internally Displaced Peoples Camps in North-East Nigeria are at great risk of rape and sexual assault and many are forced to trade sex for material gains, favour, or food. Due to lack of access to either contraception or safe abortion, this leads to disproportionally high rates of unsafe abortion and consequent injury and death.

The project run by CENPAD aims at reducing this by using a harm reduction approach to ensure that women and girls have improved knowledge and access information on menstrual regulation through medication, alongside increased access and uptake of post-abortion contraception. Thereby ensuring that the women and girls whose rights have already been violated are not further violated by forced pregnancy, death or disability. 

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RWANDA - HEALTH DEVELOPMENT INITIATIVE (HDI)

Despite a revised penal code in 2012 which allowed for abortion in cases of rape, incest, forced marriage or when continuing the pregnancy would pose a risk to the health of the woman or the foetus, it is very difficult to access a legal abortion in Rwanda. A court order is required in most cases and the majority of women do not know that they might be eligible for a legal abortion. Sex workers are particularly vulnerable, with their rights to medical care and information being regularly violated. 

HDI’s project hopes to reduce unsafe abortions and rights violations by raising awareness of the current law and improving the quality of abortion counselling information given, by training health care counsellors and gender-based violence officers to provide non-judgmental and stigma-free counselling and information.
 


Sao Tome and Principe - Santomense Association for Family Promotion (ASPF)

In 2015 the West African Island nation Sao Tome and Principe liberalised its abortion law based on its commitment to the Maputo Protocol. This 2015 law allows for abortion on demand during the first 12 weeks of pregnancy and after that in cases of rape, incest, foetal anomalies and when the health of the woman is at risk. However, national guidelines and standards for their implementation are not up-to-date and new abortion provision technologies have not been adopted. Access to safe care is therefore still limited.

The Santomense Association for Family Promotion (ASPF)’s SAAF project aims to work with the government to develop and approve national guidelines and standards that guarantee the implementation of the abortion law. This will allow for abortion care to be available within the public health system. ASPF will also work with the government to train providers in the provision of abortion care in accordance with the latest WHO recommendations and will continue to provide safe abortion care in its own clinic in the capital Sao Tome. 


South Africa - The Health Foundation

Despite South Africa’s liberal abortion laws, abortion is still a contentious issue and women face several barriers accessing care. One major barrier is lack of public health facilities which provide this care. Nurses working in abortion care report experiencing stigma and discouragement from management, colleagues and their communities. They often experience isolation and burn-out, contributing to absenteeism and poor retention.

In order to mitigate this challenge, The Health Foundation aims to work with the Department of Health to increase the acceptability and availability of abortion care in a rural district of the Western Cape by addressing staff and management attitudes towards abortion through Values Clarification Workshops, increasing service capacity by training and mentoring new providers, improving retention through debriefing and peer support, increasing awareness among surrounding communities about the availability of abortion care services and increasing the sustainability of these initiatives by training and mentoring health department staff.


UGANDA- The Association of Obstetricians and Gynecologists of Uganda (AOGU)

The Association of Obstetricians and Gynecologists of Uganda (AOGU) is professional organization founded in 1985 with the mandate to promote professionalism, undertake research, represent its members at local, regional, international level, as well as champion Sexual Reproductive Health and Rights of the people in the region.

Unsafe abortions contribute approximately a third of all maternal deaths in Uganda. The project aims to use the harm reduction model to reduce abortion related morbidity and mortality among young women by preventing unwanted pregnancies through improved access to post abortion care, post-abortion counselling and uptake of contraception. 
 


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UGANDA- THE COMMUNITY HEALTH RIGHTS NETWORK (COHERINET)

Abortion is legally restricted in Uganda but extremely widespread. COHERINET was founded as a network of activists aiming to increase information on the safe use of medical abortion in the country. 

This project hopes to empower women by increasing their knowledge about about safe abortion with pills by launching a sexual health hotline. It also plans to implement community level strategies to advance the roles of lay health workers and promote the hotline widely among particularly vulnerable groups. The project also aims to improve the operating environment for safe medical abortion service providers by sensitizing Ministry of Health officials, law enforcement officers and human rights organisations on sexual reproductive health rights.
 


UGANDA - THIS ORGANISATION HAS ASKED TO REMAIN ANONYMOUS

Women and girls in northern Uganda experience extremely high rates of complications from unsafe abortions. The project will set up measures to address and prevent unsafe abortion by offering safe abortion-related services, counselling and the provision of a wide range of contraceptive methods.

Working with a network of partner clinics across the region, the project will strengthen the healthcare worker’s capacity to provide up-to-date quality services and improve community awareness of the benefits of modern contraception. 

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UGANDA - LADY MERMAID'S BUREAU

Lady Mermaid's Bureau is a small sex-workers rights organisation based in Kampala. They started their SAAF supported project in 2014 and since the start of the project have trained 7,158 sex-workers across eleven towns in information about their rights and how to avoid unsafe abortion.

You can read some stories from their project in the SAAF stories page. 


UGANDA - VOLUNTEERS FOR DEVELOPMENT ASSOCIATION IN UGANDA (VODA UGANDA)

Girls and women in rural Uganda face extreme gender inequality which is a cause and consequence of the high levels of sexual exploitation, incest and violence faced by many young girls and women. Young people have little access to sexual and reproductive health services and abortion is highly restricted.

VODA Uganda with their 'Strengthening Community Response against Unsafe Abortion' project empower young people as change-makers in their schools and communities. Unsafe abortion was once a widespread problem in the area but through the power of peer education and by working with community leaders as well as youth, community attitudes toward abortion have been transformed. Deaths due to unsafe abortion have almost disappeared and community leaders and health providers are now calling for safe abortion to be made available for more young women in need. 

You can read more about this project on the SAAF stories page. 


UGANDA - Tusitukirewamu Group

Working in the marginalised slum areas of Kampala the community based initiative, Tusitukirewamu Group, works to improve the lives of young women involved in sex work and in and out of school youth living in densely populated urban slums, with high crime rates, flooding, poor garbage disposal. Gender inequality, poverty and sexual violence are endemic and many of these young women lack information on contraception and STI prevention, which causes unintended pregnancies and hence unsafe abortions. 

Following on from succesful SAAF supported projects, this project will continue to work with peer educators and outreach workers in the community to increase awareness on the availability of high quality abortion and contraceptive services. They will support local health facilities so that they are able to provide safe abortion and post-abortion care using modern techniques and promote women’s rights and health seeking behaviour through online and offline activities, as a way of soliciting for support to fight abortion stigma, unsafe abortions and GBV cases.
 


Zimbabwe - Women's Action Group

Although abortion is legal in Zimbabwe under a number of circumstances, lack of knowledge of the law by the public and providers alike, and social stigma surrounding abortion mean that most women in need seek unsafe illegal services. 

This project seeks to raise awareness of the current legal status of abortion through engagement with different members of the Zimbabwean society using community dialogues. In addition to raising awareness, the project will seek to bring together similar organizations to advocate for policy change to make legal abortion more accessible. WAG works from a reproductive justice perspective to ensure that women and girls are fully supported to make choices and are able to access abortion and post abortion care services if and when necessary.