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Implementing the Health Indication for Legal Abortion

Implementing the Health Indication for Legal Abortion. Charlotte Hord Smith, Ipas Patty Skuster , Ipas Dr. Gloria Asare , Ghana Health Services. Unsafe abortion in Africa. 5.5 million unsafe abortions annually

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Implementing the Health Indication for Legal Abortion

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  1. Implementing the Health Indication for Legal Abortion Charlotte Hord Smith, Ipas Patty Skuster, Ipas Dr. Gloria Asare, Ghana Health Services

  2. Unsafe abortion in Africa • 5.5 million unsafe abortions annually • 36,000 women die every year—half of all abortion-related deaths in the world • African women face greatest risk of death compared to all other regions • African women 100 times more likely to die from unsafe abortion than women in USA or Europe

  3. Government commitments • Abortion should be safe where legal (ICPD para. 8.25, 1994) • Governments should train and equip health service providers and take other measures to ensure that abortion is safe and accessible (ICPD+5, para. 63(3), 1999) • Protocol on the Rights of Women in Africa (2003) • Nearly every country has some legal indication for abortion

  4. How to turn these commitments into reality?

  5. Health indication in abortion laws • Recognized in laws of over 50 countries • A barrier in some countries (eg Zambia) • An opportunity to meet women’s needs in others (eg UK, Spain) • Ghana’s law: allows abortion to protect physical and mental health of woman

  6. Ghana’s 1985 abortion law • Liberalized to improve access to safe abortion and reduce maternal mortality • Permits abortion in cases of: • rape • Incest • risk to life of pregnant woman • fetal abnormality • Physical and mental health • Never implemented: unsafe abortion 22-30% of maternal deaths

  7. Beginning in 2003… • National working group on unsafe abortion • “Safe abortion where legal” added to RH policy • 2006 stakeholder process to develop abortion care standards for the health system • Multidisciplinary (healthcare professionals, lawyers, MOH/GHS staff from several areas)

  8. Examining the health indication • Literature and expert opinion review about mental health and abortion • How does language of law affect women in practice? • Used WHO definition of health: “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”

  9. Health indication (cont.) • No psychiatric evaluation required • Standards require provider to determine the client’s emotional distress, current and future, through counseling • Standards finalized, disseminated, and in use • Safe abortion beginning to be provided in several regions

  10. Challenge to the audience • Read and understand your abortion law: see • How is it being interpreted? • Does it adequately protect women’s lives and health? • Does it include unnecessary barriers? • Reconsider how it is being interpreted to allow maximum access to safe abortion for women in need

  11. Thank you!

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