HEARD | Sexual & reproductive health & rights

Back to News

Gender Equality and Health | 10.06.2016

Sexual & reproductive health & rights – our approach

In the era of Sustainable Development Goals, the importance of linking sexual and reproductive health and rights (SRHR) with HIV is rightly recognised.

In Africa, most HIV infections are sexually transmitted or are associated with pregnancy, childbirth, and breastfeeding; moreover, sexual and reproductive ill-health and HIV also share root causes, including poverty, gender inequality, and social marginalisation of vulnerable groups. Success in reversing these trends will require a far stronger focus in national level research on underlying drivers of discrimination, be they rooted in gender, wealth, ethnic, regional, religious and other identity-based inequalities.

HEARD will seek to materially influence the national agendas on SRHR at several levels. We shall strengthen our data and analytical capabilities to inform approaches to tackling issues around access and protection of rights, particularly for marginalised and vulnerable groups including LGBTI.

We will advocate for stronger linkages between SRHR and HIV as a route to improving health outcomes by improving access to and uptake of services, reducing stigma and discrimination, streamlining services and reducing duplication of efforts, increasing the efficient utilisation of human resources, and increasing cost-effectiveness. These benefits and the importance of linkages have been recognised in key international and regional agreements including the Maputo Plan of Action.

UNSAFE ABORTION IN EAST & SOUTHERN AFRICA – OUR RESEARCH

We’ve embarked on a new and important initiative within its Sexual and Reproductive Health and Rights research agenda, to investigate unsafe abortion in Eastern and Southern Africa.

Unsafe abortions have devastating effects on women’s health, and the rates of unsafe abortion are higher in East Africa than in any other region of the world. Southern Africa has a number of countries where abortion laws have been liberalised, but still rates of unsafe abortion remain far too high.

WHO in its Safe abortion: technical and policy guidance for health systems (2012), advises that an enabling regulatory and policy environment is needed to ensure that every woman who is legally eligible has ready access to good-quality abortion services. Policies should be geared to respecting, protecting and fulfilling the human rights of women, to achieving positive health outcomes for women, to providing good-quality contraceptive and family planning information and services, and to meeting the particular needs of poor women, adolescents, rape survivors and women living with HIV.

We seek to contribute to efforts towards a better understanding of unsafe abortion and post-abortion care issues and how best to address them. In June 2015, we conducted a comprehensive review of available literature on abortion in the East and Southern African region, published since 2000.

The review of 98 documents revealed a literature focused around five key themes: (i) the magnitude of unsafe abortion and maternal morbidity and mortality; (ii) abortion-related legislation; (iii) abortion practices; (iv) abortion-related services, and; (v) community perspectives on abortion. However, the review also revealed a considerable gap in recent and rigorous data, particularly on magnitude, practices and services, which is hampering evidence-based law-and policy-making and hindering efforts towards service improvement.

Following our literature review, we undertook phase one of our unsafe abortion research in November and December 2015: scoping studies in four countries – Malawi, Namibia, South Africa, and Tanzania – to gather stakeholder perceptions of the current key abortion issues facing each country (findings shown below) and priority areas for research.

Informed by phase one findings, phase two of our research is a multi-country rapid assessment of the occurrence of unsafe abortion complications and the provision of post abortion care in three countries – Kenya, Malawi, and Namibia.

Specifically, we seek to: (i) investigate the burden and types of complications that occur in women as a result of an unsafe abortion; (ii) assess the provision of post abortion care services at different levels of the health system, and; (iii) explore country achievements and challenges in providing universal access to post abortion care (iv) undertake a country comparative analysis for greater analytical reach. Phase two will be completed by end of 2016.

RESOURCES

Malawi, Namibia, South Africa and Tanzania key abortion issues infographics