Asia and the Pacific
BANGLADESH - BANGLADESH WOMEN’S HEALTH COALITION (BWHC)
Sylhet division has one of the lowest contraceptive prevalence rates in Bangladesh. As a result, unwanted pregnancy is common. Although safe abortion is available in Bangladesh, geographical difficulties, poverty, lack of education and social and cultural stigma prevent women getting access. Many female tea workers and ethnic minority groups also prefer to receive abortion and other sexual and reproductive health services from traditional healers that are not always safe.
Under the SAAF project BWHC will work with these communities to raise awareness of safe abortion and contraceptive options. Improve the quality of abortion-related services provided and reduce the stigma in the community. With the overall goal of ensuring that marginalized ethnic minority girls and women tea-workers in north-eastern Bangladesh have access to safe, comprehensive, stigma-free abortion care and other sexual and reproductive health services.
Nepal - Action Works Nepal (AWON)
Despite abortion being now legal in Nepal and a recent policy that provides free safe abortion care at government health services, many people are not aware of the change in the law and there are many communities that lack access to trained registered providers. With this SAAF project that continues on from previously SAAF supported work, AWON is working towards a goal where women and girls in Nepal are able to realize their rights to sexual and reproductive health and are informed and able to access contraception, safe abortion when needed.
They hope to achieve this by working with local health workers in public health posts in the Himalayan district of Kalikot to ensure that they are trained and able to provide safe quality abortion care. They will also work directly with the local communities in the area to ensure that women are aware that the services are available. By working with the entire community as well as through radio and other media, AWON also aims to reduce the abortion related stigma that prevents many women seeking legal safe care.
Nepal - This organisation has asked to remain anonymous
This anonymous organisation champions a local movement for overall development of all people including sexual reproductive health and rights. Working in the under-served region of Gorkha in Nepal, the project aims to increase knowledge about safe abortion and access to safe services in districts where, despite the liberal law most women are still using unsafe abortion methods.
They will work directly with public health providers, ensuring that they are trained and qualified to provide quality care while also educating the community on the dangers of unsafe abortion and empowering women to seek safe abortion and contraception care in public health facilities.
The organisation will also work directly with young people providing comprehensive sexuality education to boys and girls in schools to increase knowledge of SRHR issues and break down taboos.
INDONESIA - INSTITUTE FOR WOMEN HUMAN RIGHTS OR INSTITUT HAK ASASI PEREMPUAN (IHAP)
IHAP has a mission to ensure the realization of women’s human rights through public education and community organizing.
As part of a youth focussed project that is already being run to strengthen young people’s awareness on sexual and reproductive rights, they intend to use the SAAF funding to support efforts to ensure access to safe abortion services for rape survivors in the East Nusa Tenggara region. They also intend to decrease abortion related stigma through the creation and support of youth networks and the creation of local working groups made up of health professionals and local government officials.
INDONESIA - SAMSARA
Contraception in Indonesia is illegal for unmarried women. Despite a taboo against pre-marital sex, many young people do have boyfriends and girlfriends and consequently unwanted pregnancy is high. Abortion is also highly restricted and most people believe it is entirely illegal.
Samsara was founded in 2008 as a hotline and website to provide accurate information on various sexual and reproductive health issues including unwanted pregnancy.
Having been supported by SAAF since 2013, Samsara hopes to continue to increase access to information for under-served women by establishing and mentoring four local hotlines in remote regions of Indonesia so that women in those areas are able to access support in their own language.
They also hope to reduce the stigma related to abortion by showcasing some of the stories of the women that they serve and educating the community on the need to change attitudes and laws that harm women and girls.
PAKISTAN - PEACE FOUNDATION
The desert district of Tharparkar in south-east Pakistan has high levels of extreme poverty. The local health department does not cover all villages, meaning that many women in the region are without access to reproductive health services. Extreme levels of gender inequality and rigid gender norms also deny women information about their rights leading to very high levels of unsafe abortion.
Abortion in Pakistan is legally allowed if it is ‘providing necessary treatment’. Peace Foundation works by providing free medical camps to women, providing contraception and reproductive healthcare including medical abortion and running a hotline that women can call to get information on sexual and reproductive health. They also set up broad-based community linkages generate discussions and debates on the risks of unsafe abortion.
PAKISTAN - SHIRKAT GAH WOMEN'S RESOURCE CENTER (SHIRKAT GAH)
There are many impediments stopping women from realising their sexual and reproductive rights in Pakistan. However, by building on success from their previous SAAF funded project, Shirkat Gah are confident that they can produce results. Evidence strongly suggests that creating an enabling environment by removing stigma, sensitising stakeholders, training service providers, ensuring a confidential referral pathway, and developing local champions is central to ensuring attainability of services, reducing unsafe abortion and preventing deaths amongst women.
This project intends to scale up previous activities in three districts in Sindh and Baluchistan provinces while expanding to a further four new districts with an overall goal that they will be able to bring about sustained positive attitudinal and behavioural change towards abortion, promote women’s access to sexual and reproducitve health and rights information and services, and reduce gender inequalities that curtail women and girls’ reproductive choices.
SOLOMON ISLANDS - SOLOMON ISLANDS PLANNED PARENTHOOD ASSOCIATION (SIPPA)
The Pacific island country of the Solomon Islands experiences extremely low contraceptive prevalence use, high rates of unintended pregnancy, and widespread sexual and gender-based violence. Despite this, there is limited evidence of unsafe abortion practices in the country.
This project run by the Solomon Islands Planned Parenthood Association will conduct research in three provinces in the country in order to understand the practices and health impacts of unsafe abortion in rural areas.
The timing of this research is particularly pertinent as the SI Penal Code is currently under review and abortion has been identified as an area for review by the Law Reform Committee. This project therefore aims to build a strong evidence base for advocacy efforts to prevent unsafe abortion, engage law and policy makers and encourage an enabling environment to discuss safe and legal abortion.
vietnam - Population, Health and Development (PHAD)
Although abortion is legal and accessible in Vietnam, Internalized abortion stigma (IAS) affects many young and unmarried women who have had an abortion, and is associated with persistent negative health-related outcomes including low self-esteem and mental health disorders. IAS may also increase women’s engagement in high-risk behaviors including harmful alcohol consumption, drug use and unprotected sex.
The SAAF supported project run by the Institute of Population, Health and Development (PHAD) is an operation research study aimed at reducing IAS. They plan to develop a post-abortion web-based counseling intervention, evaluate its effectiveness and conduct a process evaluation. They hope that by accessing web-based information, a forum and supportive online chat with trained counsellors, participants will be able to manage IAS-related emotional distress, reduce their risk of mental health consequences, and increase their uptake of contraceptive methods.
vietnam - Vietnam Family Planning Association (VINAFPA)
Despite abortion being legal in Vietnam, issues of gender inequality, lack of access to SRHR information and quality contraceptives means that unwanted pregnancy and the consequent need for abortion care remains high. The public health system is not able to adequately meet the demand especially in rural and mountainous or disadvantaged areas, has many limitations in terms of equipment, skills and attitudes. As a result, most women prefer to private health facilities for abortion however many women cannot afford the fees hence women regularly receive unsafe abortion services.
Continuing on from a previously SAAF supported project, the Vietnam Family Planning Association (VINAFPA) will focus on reaching this population of poor, marginalized, socially excluded and underserved (PMSeU), ethnic groups, migrants and young people. They will conduct activities to change attitudes, perceptions and behaviors of service providers and clients through the provision of communication materials and awareness activities in the provinces of Quang Ninh, Binh Duong, Da Nang, Nam Dinh and Can Tho. The project will also promote and distribute contraceptive methods and support the purchase of needed-equipment to improve the quality of abortion services.