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Engaging Female Sex Workers in Covid-19 Fight Project – CESOCODE Malawi

The bitter impact of the COVID 19 pandemic outbreak has affected the lives of Sex Workers in Malawi. The novel coronavirus has exacerbated the challenges of sex workers making them even more marginalized and vulnerable in the community. The sex workers compelled to live on debts with extremely high interest rates which in fact very far beyond their capacities.

Against this background Centre for Social Concern and Development (CESOCODE) with support from Urgent Fung Africa, is conducting a six-month project to protect sex workers from the COVID-19 pandemic by distributing Personal Protective Equipment (PPEs) like face masks, hand sanitizers, taped water buckets, and soaps. We are also reaching out to these sex workers with Sexual Reproductive Health services and information like condom distribution and safe abortion counseling and referrals. The goal of this project is to protect sex workers from contracting COVID 19 by creating enough awareness of COVID 19 preventive measures and protocols.

A beneficiary received a taped water bucket, hand sanitizers, soap, and face masks.

In addition, the project is extending its services by providing sexual reproductive health services like condom distribution and safe abortion information to enable Sex workers to have access to Sexual Reproductive Health services and information during the COVID-19 pandemic when many health facilities are closed and lockdowns and services are limited.

 We are conducting one to one safe abortion counseling sessions with sex workers through counseling experts.

We conducting door-to-door condom distribution to sex workers to prevent them from unplanned pregnancies.

We conducted a COVID-19 prevention training for sex workers to provide awareness on preventive measures and protocols of COVID 19 enforced by the Government like hand washing, maintaining physical distance, wearing masks, and so on.

A group photo of the sex workers with their COVID-19 PPEs received.

MAMA Network asks UN Experts to take action on Self Managed Abortion

In a session with IPAS, CRR, and FIGO alongside other human rights advocates and health workers, the MAMA Network was invited to speak with UN treaty bodies and address existing barriers in accessing self Managed Abortions. Jedidah Maina who represented the MAMA Network asked that UN Experts urge member states to completely decriminalize all abortions.

As MAMA, we believe and understand that abortion with pills creates a universal opportunity for safe abortion and that access to abortion with pills also enforces several human rights.

‘There continues to be cultural taboos that prevent open dialogue in homes and in school and sometimes our laws and policies do not mirror the lived realities of women/girls… the law criminalizes self-care/abortion management… We [Mama network] increase access to medical abortion as a safe, effective medical procedure outside a clinical setting… we think this is a revolution, and women have this in their hand – it has the potential to make so many abortions in our continent safe and that States need to adapt their laws to reflect this lived reality of people who have abortions.’ Jedidah Maina (MAMA Network coordinator)

The Take away from the discussion tasks UN Experts to raise in-depth conversations with governments to assess their progress on ensuring safe abortion. These questions range from the legality of abortion in specific countries, the availability of misoprostol and mifepristone which are essential medicines in reproductive health and clarifications on regulations surrounding telemedicine.

The MAMA Network has established reproductive health and safe abortion hotlines / helplines in 13 countries across Sub-Saharan Africa. 97% of unsafe abortions occur in Sub-saharan Africa and the risk of dying from an unsafe abortion is highest in the region. Our helplines operate 24//7 to help people who need information, guidance and support.

“Beyond Our Society’s Eyes” – Zambia’s abortion reality according to CTYA

The issue of unsafe abortions is actually beyond what appears apparent to the naked eyes in the Zambian society which is praised for being a Christian society. Approximately 23% of incomplete abortions in Zambia are among women younger than 20 years, and 30-50% of gynecological admissions at the University Teaching Hospital result from unsafe abortion-related complications (Standards and Guidelines for Reducing Unsafe Abortion Morbidity and Mortality in Zambia-Ministry of Health). For every 1,000 women ages 15-29 in Zambia, there are over 30 deaths per year resulting from unsafe abortion, thousands more suffer injuries.

Findings on girls aged 13 -19 years old aimed at describing adolescent girls’ circumstances underlying the decision to resort to unsafe induced abortions found that most of the girls who resorted to unsafe abortions were single, in school, nulliparous with inadequate information on contraceptives. It was further found that the adolescent girl’s reasons for resorting to an unsafe abortion were fear of stigma and discrimination due to premarital conception such as parental disapproval, expulsion from school, and abandonment by the person responsible for the pregnancy.

In 2019, Contact Trust Youth Association (CTYA) conducted a mapping exercise to explore abortion stigma, its root causes, and related values, norms, and culture in the community in order to identify and document important community characteristics and issues that need to be addressed. Although most interviewed girls and young women were well aware of available medical abortion services in health facilities, they preferred using unsafe methods to going to clinics as they felt altitudes among health practitioners were a ‘let-down’.

“I tried drinking undiluted Mazoe drink and Muzwezi (local plant) boiled water but the pregnancy did not come out but left me sick for a couple of weeks, I could not come to the clinic because I was shy and have heard nurses shout at people before they can attend to them.” (Focus group discussion participant).

There is good evidence to suggest that adolescents (10–24 years) are at a greater risk of experiencing ‘illegal’ or ‘unsafe’ invasive procedures than older women, and are thus worthy of special attention. Illegal abortion in adolescents is linked to earlier onset of sexual activity, earlier pregnancy, and greater ignorance of contraception as compared with women seeking legal abortions.

Access to safe abortion in rural areas amidst COVID-19

VIAC and R2G are both MAMA member organizations advocating for access to safe abortion information and for access to safe abortion services in rural communities. The COVID19 pandemic has exposed many barriers for women in accessing safe abortion, especially women in rural areas. Lack of access to information and the lack of access to services has negatively impacted rural communities.

Availability and distribution of abortion care facilities can influence women’s access services, especially in rural areas. Existing community stigma makes it difficult for women to access services or to seek safe abortion information.

“In the rural areas, the health centers closer to women do not offer abortion services and the providers working in the centers are neighbors to the women in the community. This makes it hard for women and girls to approach them for support even if it’s safe referral support. There is that fear”. Says a representative from R2G

In Cameroon, those who seek abortion services in rural areas don’t know their rights to abortion. VIAC runs a reproductive health hotline where women can call to get information and counseling on self-managed abortion with pills. To reduce maternal mortality, grassroots organizations need to empower women to know their rights by making information and services accessible in their vicinities.

“The advocacy for abortion services in rural communities is very insignificant. There is a need to strengthen community-based organization alliance for more of better advocacy programs” Says a representative from VIAC.

To strengthen grassroots efforts, the Mama network is providing support to organizations working or at the frontline in community advocacy on access to abortion information and self-managed abortion information.

For access to safe aboriton information and access to services, reac out to any of the MAMA hotlines in the region: https://mamanetwork.org/network/helplines/

Regional efforts to advance access to safe abortion services

In December 2020, with the ease of restrictions on movement and adherence to safety measures, the Reproductive Health Network in Kenya held it’s 4th Annual Science Conference on Youth & Adolescents SRHR with the theme “Adressing the three zeros by prioritizing adolescents and young people’s SRHR. The MAMA Network presented an abstract to share practices and lessons learned in ensuring access to safe abortion regionally.

The risk of unintended pregnancies among adolescent girls and young women is greater due to the global pandemic of COVID19. Integrated interventions for Adolescent girls and young women with efforts to address early and/or unintended pregnancy, unsafe abortion, sexually transmitted infections, and combat violence against women and girls ensure that adolescent girls and young women have the power to make decisions over their own lives. With the current world order, the need for information and access to safe services is primordial to combat unsafe abortions and ensure access to reproductive health services.

The MAMA Network supported the launch of 11 hotlines, with 6 launched in these times of the pandemic. The hotlines have played a significant role to give adolescent girls and young women access to sexual and reproductive health and rights information, in particular safe abortion and contraceptives.

To strengthen leadership at the grassroots level and facilitate networks of local and regional activists to work towards a shared goal a two (2) weeks training program on hotlines followed by weeks of mentorship designed by TICAH and WHW supports member organizations to launch hotlines in their community. The first 6 months of the lockdown and COVID19 restrictions worldwide saw 9 organizations with ready resources for implementation virtually trained and 6 hotlines launched. The 9 participants came from Kenya, Liberia, Congo Brazzaville, DRC Congo, Nigeria, South Africa, and the Gambia.

Hotlines Save Lives – Join us this September 28th

This September 28th to commemorate the international day of access to safe and legal abortion, the MAMA Network will run a campaign to highlight the importance and impact of hotlines in these times of global pandemic. Join the conversation on our twitter @themamanetwork and make sure your voice is heard using the hashtags #HotlinesSaveLives and #ImanageMyAbortion.

There is a growing need for reproductive health hotlines for women to access information on contraceptives, safe abortion and self-managed abortions. Since March 2020, The MAMA Network has launched 6 new hotlines in 6 different countries. The Democratic Republic of Congo, Zambia, Cameroon, South Africa, Liberia and the Republic of Congo (Brazzaville). To date, there are 11 MAMA Hotlines across sub-Saharan Africa giving information on contraceptives and safe abortion options.

The pandemic has made access to reproductive health information and services difficult globally. Because of the restrictions on movement and limitations to reproductive health services, we have seen – especially in low- and middle-income countries – a significant surge in unwanted pregnancies and unmet needs for contraceptives.

Reproductive health hotlines provide callers with accurate information, tele-counseling, and referrals to quality care. This saves women’s lives and reduces unsafe abortion in countries where abortion is restricted or criminalized. Hotlines promote women’s autonomy and put power into women’s hands to make the right choice for their reproductive health.

Access to safe abortion remains a priority and an essential service. Across MAMA Hotlines we have seen an increase in women taking back their power and make the best choices for themselves free of stigma or coercion.

In the months of January to June, we recorded more than twenty thousand calls for safe abortion access across 5 hotlines at the time. Hotlines have redefined access to information and services for women living in developing countries, and that’s why this #Sept28 we invite you to check MAMA’s Hotlines and our new video (https://www.youtube.com/watch?v=-Br79lhnd1s&t=2s) highlighting that #HotlinesSaveLives!

Video testimonies on the effectiveness of abortion with pills

An estimated 93% of women of reproductive age in Africa live in countries with restrictive abortion laws. Even in countries where the law allows abortion under limited circumstances, it is likely that few women are able to obtain a safe, legal procedure.
Countries in African can be classified into 6 categories, according to the reasons to which abortion is legally permitted.
Between November 2018 and April 2019, the MAMA Network conducted a study with community leaders and health workers in five sub-Saharan Africa countries (DR Congo, Kenya, Malawi, Nigeria, and Tanzania) to assess safe abortion activism, and the impact of the safe abortion services provided by MAMA organizations in each of their communities.
Community members expressed a preference for medication abortion over other abortion methods due to effectiveness, privacy, cost, and safety.

“The pills are much better because women don’t have to go to a public hospital to have the abortion. Hospitals have too many people which eliminate privacy. With pills, a woman can do everything in her bedroom at an early stage of the pregnancy, according to the advice she received during training. If all the advice is followed, the woman is protected and the matter remains private.” (Community leader, Malawi).

“Abortion with surgery is expensive…abortion with pills like I said is affordable, it is more effective according to the WHO standards and I have seen ladies who used it and they came to testify that they used it, it works and they are back again. For me, I would go for that pill.” (Community health worker, Nigeria).

Unsafe abortion continues to be a persistent public health problem that accounts for an estimated 13% of all maternal deaths globally. In East Africa nearly 1 in 5 maternal deaths can be attributed to unsafe abortions. Abortion with pills or abortion with Mifeprostone or/and misoprostol is safe as per WHO guidelines.

MAY 28th – Abortion Beyond LockDown (The Campaign)

May 28 is the International Day of Action for Women’s Health, which for over 30 years, women’s rights advocates and allies in the sexual and reproductive health and rights (SRHR) movement worldwide have commemorated in diverse ways. Year after year, women, girls, advocates and allies have continued to take action and stand up for sexual and reproductive rights for what they are: an indivisible and inalienable part of our human rights.

On this day, the MAMA Network ran an online campaign to convey the message that ”Abortion is Essential” and Abortion is still an essential service amid the COVID-19 Pandemic. Between May 25th and 28th MAMA Network members engaged in an online Advocacy Campaign for the International Day of Action for Women’s Health with the hashtag #AbortionBeyondLockdown MAMA believes that no laws, no diplomas, no stigma and no pandemic should be gatekeepers to reproductive justice.

The COVID19 pandemic has placed many barriers to access abortion and
exposed the unnecessary requirements set by the laws in place. Still aligned to MAMA’s main objective to expand access to services and information about abortion with the pills, MAMA Members were in solidarity to share the message that self-managed abortion is safe, effective, discrete, and can be done at home.

  • 13 organizations from 9 countries participated in the campaign.
  • A total of 53 solidarity images and 3 solidarity videos of the campaign were received.
  • The total reach for the campaign was 1,575 with the most active countries being Nigeria and Kenya.
Let’s connect on Twitter: https://twitter.com/themamanetwork

#WeMadeInroads! and #MarchedForChoice!

After a successful reunion at ICPD+25, yet again MAMA Network brought its influence at the Inroads Global Gathering to share experiences, research findings, achievements, lessons learned and expertise. The ICPD+25 2019 marked the 25th anniversary of the International Conference on Population and Development (ICPD) in Cairo, where 179 governments adopted a landmark Programme of Action which set out to empower women and girls for their sake, and for the benefit of their families, communities and nations.

Prior to ICPD+25, the MAMA Network was invited to the WGNRR pre-icpd+25 gathering to speak on the importance of movement building for Reproductive Rights Activists and together discuss how MAMA Network’s shared experience can ensure a cohesive voice during ICPD+25.

Early this year in 2020, MAMA Network actively contributed to the Inroads Global Gathering by leading and facilitating sessions. MAMA Network team took leadership to organize sessions on networking, holistic security, the state of abortion in Kenya – the host of the Inroads gathering and was honored for space and opportunity to share its scientific findings on abortion and medical abortion in Africa.

Right before we closed the year, the MAMA Network organized its own regional gathering were 25/35 of the member organizations came together to share impact and strategize for the common goal ahead.

To mark a successful and impactful movement of reproductive health and rights activists in sub-Saharan African, the last 2 quarters were graced with an honorable invite in the Republic of Congo to speak on advocacy, networking, and holistic security for grassroots activists. A regional gathering of Francophone organizations in the region.

Activists proclaim ‘Safe Abortion is Healthcare’ on Sept 28th, 2019.

28 September is International Safe Abortion Day. The day was first celebrated as a day of action for the decriminalization of abortion in Latin America and the Caribbean in 1990. In 2011 it was declared as an international day. September 28th, 2016 was the biggest International Safe Abortion Day ever celebrated. Many groups took action. September 2016 also marks the birth of the MAMA Network.

Community outreach by a network member engaging in dialogues to advocate for women and girls’ access to comprehensive Sexual and Reproductive Health and Rights.

September 28th, 2019 the MAMA Network records a total of 35 member organizations from 16 Sub-Saharan African Countries, including partners in the Netherlands and in the United States. Implemented activities on this day unified reproductive health and rights activists and saw ‘access to safe abortion’ trending across the globe.

Regional Conference held to disseminate findings of the Global Gag Rule Year 2 findings and strategize on a way forward to ensure that women and girls access safe abortion.

The global gag rule (GGR) is the silencing of organizations on abortion advocacy. It has been proven by IWHC and IPPF that silencing abortion only reduces safe abortion for women and girls and not the cases of abortion. In addition to this, there is a misunderstanding surrounding the global gag rule (GGR) which further creates a gap for women and girls in need of accessing safe abortion care.

MAMA Member COHERINET joined health service providers and the community people to showcase the need to bridge the gap between the community people and the health facilities due to high levels of stigma associated with abortion care.

In DRC articles 165, 166 supports safe abortion to save the life of the woman but factors such as stigma and misinformation lead women to not accessing the service. A conference was held to bring clarity among women in the community and educate women on the use of misoprostol to save women’s lives against postpartum hemorrhage (PPH). Maternal mortality and morbidity is a global issue that needs to be handled with urgency.

International day of safe abortion themed ‘Abortion is Healthcare’ by MAMA network member organization. September 28th, 2019.

The MAMA Network also held a twitter chat to disseminate a desk review report that acted as the basis for onground research on women’s access to abortion and to evaluate the effectiveness of onground implemented activities. The twitter chat held on September 27th and September 28th reached an audience of 4,481 people and grew it’s following by 50%.