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Abortion laws and policies in Malawi and Zambia Dr Ernestina Coast Dr Emily Freeman London School of Economics Abortion Research to Policy Addis Ababa 30 th November 2016 Why compare countries ID: 535131 Download Presentation

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Critical conjunctions: Abortion laws and policies in Malawi and Zambia

Dr Ernestina CoastDr Emily FreemanLondon School of EconomicsAbortion Research to Policy. Addis Ababa 30th November 2016Slide2

Why compare countries?Contrasts

SimilaritiesCommonalitiesPatternsStakeholdersArguments

EvidenceMotivationsProcessesOutcomes}Slide3

Current legal positionsMalawi

Abortions can be legally performed to save the life of the pregnant woman.

ZambiaContinuing a pregnancy involves a risk to the life of the pregnant woman, her physical or mental health or that of any of her existing children, greater than if the pregnancy were terminated; or a child born of the pregnancy would suffer from such physical or mental abnormalities as to be seriously handicapped. M

edical

practitioners may take account of the pregnant woman’s actual or foreseeable environment and her

age

E

xplicitly includes

rape or defilement of a female child as legal reason for inducing

abortion and to exempt

from prosecution female children who have attempted to self-abort in these circumstancesSlide4

Contexts todayMalawi

Draft Termination of Pregnancy BillNot yet before ParliamentLiberalisation of grounds on which abortion may be performed legally to include

Danger to lifePhysical + mental healthMalformation of the foetusRapeDefilementIncest

Zambia

2016 Referendum on changes to the Bill of Rights in the Constitution

Para 15(2) “The life of a person begins at conception”

Threshold of 50% of eligible voters not met (44% achieved)

Unclear next stepsSlide5

Contexts todayMalawi

Draft Termination of Pregnancy BillNot yet before ParliamentLiberalisation of grounds on which abortion may be performed legally to include

Danger to lifePhysical + mental healthMalformation of the foetusRapeDefilementIncestZambia

2016 Referendum on changes to the Bill of Rights in the Constitution

Para 15(2) “The life of a person begins at conception”

Threshold of 50% of eligible voters not met (44% achieved)

Unclear next stepsSlide6

Malawi

Highly restricted legal groundsLiberalisation?

ZambiaBroad range of legal grounds

Restriction?Slide7

Sources of evidencePrimary Media reports (print and social)Key informant interviews

Documents (including drafts)SecondaryResearch and evidenceSlide8

A PARTIAL HISTORYSlide9

TOP Act

TOP Act amended

Ratified Maputo Protocol

Ipas starts

working

Strategic assessment

unsafe

abortion

Post Abortion Task Force established

Standards &

Guidelines

ToP

Act amended

Planned Parenthood Association of Zambia

established

Ipas

establishes full country programme

International treaties

National instruments

Ministries

NGOs

Marie Stopes

Zambia: abortion

services

1972

2016

2000

1994

2005

2006

2008

2009

2011

2012

1st

Draft

of Constitution

“life begins at conception”

Referendum: inquorate

Ratified Maputo Protocol

1930

Penal Code

Communique signed by leaders of 11 political parties supporting law reform on abortion

Ipas starts

working

COPUA established

1987 BLM started

Strategic assessment

unsafe abortion

1987

Draft

Bill

2015

2007 PAC Strategy

Evidence

2007

2013

Law Commission review published

Health systems costs

Abortion incidence

2010

Standards &

GuidelinesSlide10

LEGAL LANDSCAPESlide11

TOP Act

TOP Act amended

Ratified Maputo Protocol

Ipas starts

working

Strategic assessment

unsafe

abortion

Post Abortion Task Force established

Standards &

Guidelines

ToP

Act amended

Planned Parenthood Association of Zambia

established

Ipas

establishes full country programme

International treaties

National instruments

Ministries

NGOs

Marie Stopes

Zambia: abortion

services

1972

2016

2000

1994

2005

2006

2008

2009

2011

2012

1st

Draft

of Constitution

“life begins at conception”

Referendum: inquorate

Ratified Maputo Protocol

1930

Penal Code

Communique signed by leaders of 11 political parties supporting law reform on abortion

Ipas starts

working

COPUA established

1987 BLM started

Strategic assessment

unsafe abortion

1987

Draft

Bill

2015

2007 PAC Strategy

Evidence

2007

2013

Law Commission review published

Health systems costs

Abortion incidence

2010

Standards &

GuidelinesSlide12

NGO presence/activitySlide13

TOP Act

TOP Act amended

Ratified Maputo Protocol

Ipas starts

working

Strategic assessment

unsafe

abortion

Post Abortion Task Force established

Standards &

Guidelines

ToP

Act amended

Planned Parenthood Association of Zambia

established

Ipas

establishes full country programme

International treaties

National instruments

Ministries

NGOs

Marie Stopes

Zambia: abortion

services

1972

2016

2000

1994

2005

2006

2008

2009

2011

2012

1st

Draft

of Constitution

“life begins at conception”

Referendum: inquorate

Ratified Maputo Protocol

1930

Penal Code

Communique signed by leaders of 11 political parties supporting law reform on abortion

Ipas starts

working

COPUA established

1987 BLM started

Strategic assessment

unsafe abortion

1987

Draft

Bill

2015

2007 PAC Strategy

Evidence

2007

2013

Law Commission review published

Health systems costs

Abortion incidence

2010

Standards &

GuidelinesSlide14

EVIDENCE PRODUCTION + CONSUMPTION“National policy change usually begins with documentable evidence of the problem and clear articulation of solutions.” IPAS,

2016Good reproductive health policy starts with credible research (Guttmacher

)Generating evidence for policy and practice (APHRC)Slide15

TOP Act

TOP Act amended

Ratified Maputo Protocol

Ipas starts

working

Strategic assessment

unsafe

abortion

Post Abortion Task Force established

Standards &

Guidelines

ToP

Act amended

Planned Parenthood Association of Zambia

established

Ipas

establishes full country programme

International treaties

National instruments

Ministries

NGOs

Marie Stopes

Zambia: abortion

services

1972

2016

2000

1994

2005

2006

2008

2009

2011

2012

1st

Draft

of Constitution

“life begins at conception”

Referendum: inquorate

Ratified Maputo Protocol

1930

Penal Code

Ipas starts

working

COPUA established

1987 BLM started

Strategic assessment

unsafe abortion

1987

Draft

Bill

2015

2007 PAC Strategy

Evidence

2007

2013

Law Commission review published

Health systems costs

Abortion incidence

2010

Regulatory Impact AssessmentSlide16

MalawiMaputo Protocol a “trigger”Abortion “did not fit with MDGs because no evidence”Series of studies

Strategic Assessment (2011)Incidence of Induced Abortion (2013)Health systems costs (2015)Slide17

Tonight, we’re going to let the statistics speak for themselves”Slide18

Letting the evidence speak for itself?Evidence/statistics a critical entry point

“Getting the conversation going”Evidence/statistics necessary but insufficientRole of “champions”“Don’t expect me to go to my constituents – they’ll kick me out” [MP]Private agreement but public distancingCoalitionsSlide19

Zambia: Standards & Guidelines do the talkingSlide20

CROSS-NATIONAL “LEARNING” (?)Slide21

On the one hand: Malawi Law Commission on abortion visitedEthiopiaZambia

MauritiusOn the other:“Stop cheating people that liberalized abortion was justifiable because of rising cases of maternal mortality rate….We have an example of Zambia and other countries, where abortion was liberalized, yet maternal death is still on the higher

side” Ethics, Peace and Justice Commission (Evangelical Association of Malawi)Slide22

On the one hand: Malawi Law Commission on abortion visitedEthiopia

ZambiaMauritiusOn the other hand:“Stop cheating people that liberalized abortion was justifiable because of rising cases of maternal mortality rate….We have an example of Zambia and other countries, where abortion was liberalized, yet maternal death is still on the higher side”

Ethics, Peace and Justice Commission (Evangelical Association of Malawi)Slide23

Religious/faith-based groupsMalawi

USA-based evangelic Christian groups lobbying MPs (2016)Concerns about abortion and gay rights articulated simultaneouslyEpiscopal Conference of Malawi (ECM)Zambia

Zambia officially a Christian countrySouth African-based “Doctors for Life”An aside about presenting evidence:

Women who have had abortions assumed to have no faithSlide24

Pastoral Statement (2016)“We, the Bishops of the Catholic Church in Malawi are aware of the pressure that

the Government has endured so far from foreign nations and agencies who attach their financial support to values and practices that are contrary to our culture. We applaud the efforts and the courage the Government has demonstrated so far to resist the pressure to adopt such foreign values and practices i.e. homosexuality and abortion. We wish to reaffirm that such practices are not only against our cultural values but

are also contrary to our laws and beliefs.”Slide25

Religious/faith-based groupsMalawi

USA-based evangelic Christian groups lobbying MPs (2016)Concerns about abortion and gay rights articulated simultaneouslyEpiscopal Conference of Malawi (ECM)ZambiaZambia officially a Christian

countrySouth African-based “Doctors for Life”An aside about presenting evidence:Women who have had abortions assumed to have no faithSlide26

Malawi

ZambiaCoalitionsCOPUA multi-interestMedical: Little evidence of activity ( beyond individual “champions”)

Legal: Highly activeNo broad coalitionMedical: Active participation and debateAdolescents

Adolescents as stakeholders

Abortion as an adolescent issue

Abortion as an adolescent issue

Social construction of abortion discourses

“not Malawian”

“not Zambian”

Ministry “sites”

Reproductive Health Unit (

MoH

)

-

MoH

- Technical Working GroupsSlide27

Law necessary but insufficientSlide28

ZambiaServices not widely availableUrban focus (public and private)

Low levels of knowledge about the lawPublicMedical professionalsServices inaccessible3 signaturesRegulatory Impact AssessmentNo broad-based coalition (yet)Opportunity for learning from Malawi?Slide29

Malawi

Highly restricted legal groundsLiberalisation?No change?

ZambiaBroad range of legal grounds

Restriction?

Increased access?Slide30

THANK YOUe.coast@lse.ac.uk

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