Working to Advance Health Equity in Africa



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.


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.


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

Tanzania key abortion issues

Tanzania key abortion issues

South Africa key abortion issues

South Africa key abortion issues

Namibia key abortion issues infographic 2016

Namibia key abortion issues infographic

Malawi key abortion issues infographic

Malawi key abortion issues infographic

Return to list

Related news


CAREERS: Visiting Professor / Visiting Assistant Professor

HEARD invites applications for a one-year position, (2018 academic year), as Visiting Professor / Visiting Assistant Professor in any of the following areas: The Future Health Financing in Eastern and Southern Africa Sexual and Reproductive Health and Rights Universal Health Coverage HIV ...>>


HEARD at #AIDSImpact2017: Live Updates

HEARD researchers are live at the @AIDSImpact conference currently underway in Cape Town, South Africa. We’ll be sharing updates from their research presentations and discussions around key populations, health systems, HIV prevention and health financing. Tweet #AIDSImpact Tweets by HEARD_UKZN


International Safe Abortion Day – A day for action towards access to Safe and Legal Abortion

Unsafe abortion is a major cause of mortality and morbidity and has been identified as one of the key health crises on the global health agenda. Ninety-eight percent of unsafe abortions take place in middle- and low-income countries with the most deaths occurring in countries with restrictive ...>>


How do we conduct SGBV research in conflict and post-conflict settings?

HEARD in partnership with the University of Birmingham will conduct a methodological workshop to structured around a series of presentations and discussions aiming to address these questions and to result in the development of new methodological tools for research on SGBV which is both locally ...>>


Public talk: Intimate partner violence among pregnant women in low-income countries – A case study of Rwanda

Intimate partner violence during pregnancy is associated with maternal mortality, adverse pregnancy outcomes and childhood growth impairment. Its effects may be exacerbated in resource-limited settings. Nevertheless, it has not been thoroughly investigated. In this talk, Dr Akashi Andrew ...>>


World AIDS Day: Getting key populations on the Fast-Track

December 1 marked World AIDS Day. A brief moment reflection our recent achievements in the fight against HIV and AIDS point to some significant victories. Globally, we have more scientific knowledge on how the virus is transmitted with prevention and treatment options being tailored to suit ...>>


Linking policy to programming: A research project on young key populations in SADC countries

HEARD embarks on an extensive research project on young key populations in SADC countries, in collaboration with the United Nations Development Programme and African Men for Sexual Health and Rights.  We’ve successfully obtained a large research grant to conduct operational research on ...>>


UN: HIV rate in young African women disturbingly high

ARV treatment on the rise, but UN urges urgent action as thousands of young women continue to be infected with HIV. The number of HIV-infected people taking anti-retroviral (ARV) medicine has doubled in just five years, the United Nations said while highlighting high infection rates among young ...>>


2017 PhD Scholarships – Developing African Academics

HEARD’s Scholarship Programme aims to emphasise the mastery of quantitative and qualitative methods for understanding policy problems and for devising, evaluating and/or implementing policy solutions. The aim of providing PhD scholarships is to produce expertly qualified graduates to advise or ...>>


The power of friendship and conversation for preventing violence against women and girls

HEARD’s gender equality and health expert Andrew Gibbs and Nwabisa Jama Shai from the gender and health unit of the South African Medical Research Council on strengthening government, civil society and academic relationships for evidenced-based policy and programming to prevent VAWG. ...>>