VIAC is debunking myths around SRHR

With support from the MAMA network, VIAC is able to organize a good number of community interventions and research on access to SRHR information specifically on safe abortion and self-managed abortions in Cameroon. Using various techniques and strategies in community interventions, we are able to design and organize age-appropriate programs targeting different age groups within our program scope.   As a means to talk about self managed and safe abortion with pills in our setting (restrictive) we have organize seventeen (17) community outreach, held six (06) safe spaces with adolescent girls and young women, four (04) sessions with persons with disabilities and seven (07) sessions with internally displaced persons (women) in the past five months.

Our entry points have always been sexual health education, menstrual hygiene management, contraceptives including male and female condoms, and access to safe abortion information. These outreaches involved parents, whereby Vision in Action (VIAC) advocated for access to sexual reproductive health for adolescents. 

In our safe space discussion with adolescent girls and young women, we reached out to 88 AGYW in our safe space initiative. Through our sessions, we are able to create an enabling environment for them to share their stories and find empathy within the group thereby reducing abortion stigma, increasing confidence and self-esteem, and clarifying myths about self-managed abortion while sharing information on the hotline. 

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(Pic decription: A cross section of safe space discussion) 

An attained milestone for the organization is our work with girls and women with disabilities; we organize four sessions reaching out to 52 girls and women with disabilities in the region. It was amazing to see and know the needs for women with disabilities, how different the needs are and to say the least, how impactful was our session. Ranging from talking about contraceptives and menstrual health.

It’s worth highlighting that, the outcome of these activities in rural and urban areas varied as people in the rural areas had so many myths about contraceptives and sex education, highlighting stigmatization and fear of promiscuity as one of the reasons for the lack of sex education for adolescents.  In urban areas, there were a lot of misconceptions about contraceptive use. Many people attributed the usage of contraceptives (except condoms) to infertility. 

At the end of these community outreaches, a positive impact was created as they stop believing myths associated to sexual reproductive health, thus their interest grew over time as an overwhelming number of people contacted the hotline to get more information on their sexual reproductive health. Because parents of adolescents gained knowledge on the importance of sexual reproductive health, after the session, parents talked about sex education with their children. Moreover, we were called back by the parents of some communities as they gave us the opportunity to talk about contraceptives, safe abortions and sex education with adolescents. This created a free atmosphere for these children to discuss issues of their sexuality without being reproached. 

ACCOMPAGNER LES JEUNES FILLES, FEMMES ET GARÇONS SUR LA NÉCESSITÉ DE L’AVORTEMENT SÉCURISÉ.

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Les facilitateurs ont mis les points rappelant que l’entrée dans la vie sexuelle active des adolescents et jeunes représente une étape importante mais aussi très difficile pour la plupart des jeunes et adolescents. Car il faut concilier d’une part les aspects positifs et prometteurs de la sexualité «découverte, amour, partage», d’autres part les aspects négatifs «crainte d’une grossesse précoce, des maladies sexuellement transmissibles comme les IST et du VIH/SIDA». D’où la nécessité du programme sur la santé sexuelle et reproductive des adolescents et jeunes (SSRAJ). L’adolescence est caractérisée par une augmentation de contact avec le sexe opposé. Ainsi à l’éveil sexuel de la puberté s’ajoute les dimensions sexuelles amoureuses, pour certains c’est le début de relation allo sexuelle. Les conditions d’entrée dans la vie sexuelle diffèrent d’une région à une autre. Les facteurs influençant cette entrée sont notamment; les normes sociales, la foi et la spiritualité, la tradition, les médias, le prolongement généralisé des études mais aussi et surtout les avancées enregistrées dans le domaine de la contraception et pour certains pays la légalisation de l’avortement. Des nombreuses études se sont penchées sur le concept de fécondité des adolescentes et ont noté un accroissement de l’activité sexuelle des célibataires  et donc des grossesses avant le mariage. Actuellement, la socialisation sexuelle des femmes reste toujours plus contrôlée que celle des hommes, et leurs premiers rapports sont à la fois plus souvent tardifs et parfois encore mal vécus. En Afrique subsaharienne, la sexualité préconjugale est intense, précoce, instable, multipartenaire, diversement justifiée, dépendant des caractéristiques socio-économiques, sociodémographiques et socio- culturelles des jeunes et des membres de leurs ménages. 

Dans presque tous les pays, la loi permet l’avortement pour sauver la vie de la mère, et dans la majorité des pays, l’avortement est autorisé pour préserver sa santé physique et/ou mentale. Par conséquent, il faut que des services d’avortement sécurisé, tels que prévus par la loi, soient disponibles et applicable. C’est la lutte que l’ organization membre mene auprès des autorités ou les décideurs.

L’avortement non sécurisé, ainsi que la morbidité et la mortalité associées chez les femmes, sont évitables. Des services d’avortement sécurisé devraient donc être disponibles et accessibles pour toutes les femmes, dans le plein respect de la loi.

l’accès à l’avortement légal reste très limité  en partie à cause de: 

• La compréhension et l’application incohérente de la loi par  les institutions juridiques et les personnes chargées de faire appliquer les lois.

 • L’intégration lente du langage du Protocole de Maputo  dans les lois nationales. 

• Les stigmas graves contre les femmes qui cherchent ou qui  ont eu un avortement.

Ceci occasionne des avortements clandestins, non sécurisés et souvent y a perte de vies

Centre for Social Concern and Development (CESOCODE) engages Adolescent girls and young women in access to Sexual Reproductive Health services.

 

Cross-section of adolescent girls who attended the meeting  

As one way of improving access to Sexual Reproductive Health among adolescent girls and young women in Chiradzulu and Zomba districts in Malawi, the Centre for Social Concern and Development (CESOCODE) conducted Adolescent girls and young women SRH friendly meetings. The meetings were aimed at discussing different SRH issues affecting adolescent girls and young women about Youth Friendly Health Services, finding possible solutions to the challenges and strategizing on how they can deal with those challenges, and identifying and engaging possible stakeholders like pharmacists and community-based health workers who could help solve the challenges. The meetings were also aimed at strengthening and raising the capacity of adolescent girls and young women accessing SRH services at Chiradzulu and Zomba Health Centres.
 During the meetings, girls and young women shared with the gathering the different activities they are undertaking to help fellow adolescent girls and young women understand Sexual Reproductive Health issues in their communities. Some girls and young women reported using drama, forum theatre, songs, poems, and sports as strategies for disseminating information to their peers.
 Pharmacists and Community Based Health workers have a role and a responsibility to play to promote Youth Friendly Health Services and make sure that adolescent girls and young women have access to the right knowledge and services in terms of  Sexual Reproductive Health; There is a need to intensify activities aimed at educating adolescent girls and young women in Zomba and Chiradzulu districts with information on SRH issues, and adolescent girls Young women from different groups should encourage their peers to go to the health facilities every time they have Sexual Reproductive health issues but also to access Youth Friendly Health Services.

CESOCODE is conducting a six-month project in Chiradzulu and Zomba districts with financial support from MAMA Network to promote access to SRH services among adolescent girls and young women.   

Introducing the MAMA Sophia App

Sex, pregnancy, love, and health are complicated enough as it is, whether you are a young woman studying and building a career, or a parent managing a family. Matters of family planning and birth control or sexual and reproductive health, in general, are complex. 

Everyone can benefit from more trusted, reliable support! 

The MAMA Network has created a mobile phone app that will make it all simpler. The Mama Sophia app is designed to give you the confidence and convenience you need to live your best life. Mama Sophia is a free mobile app that will help you manage your period, choose effective contraception, deal with an unplanned pregnancy, and connect you with a network of qualified and empathetic experts!

Mama Sophia offers the full range of solutions for young people and women who want to not just take care, but take control of their sexual and reproductive lives, starting with a customized period tracker. Answer a few questions to establish your cycle and Mama Sophia will provide a reliable calendar with the days of your menstruation, the days you may be ovulating, and support if you miss a period. You can also reach out to Mama Sophia’s network of experts for a chat or call if you have questions. 

What about pregnancy? The Mama Sophia app can track pregnancy as well, and tell you how far along you may be. If you decide you don’t want to continue with a pregnancy, there are confidential hotlines to offer information on safe abortion and someone to talk to if you need support. Mama Sophia also has a feature for women who want to know which contraceptive method may be best for them. Just go through a quick and easy quiz that will lead you to options that suit your lifestyle and preferences.

The Mama Sophia app is a free, lightweight app from the MAMA Network and is available now in the App Store and the Google Play store. For more information on the Mama Sophia app, like and follow us on Facebook, Twitter, and Instagram. For any inquiries write to us at coordinator@mamanetwork.org or info@womenhelp.org

Pharmacists training to promote access to safemedical abortion services in Malawi

The cross section of the participants who attended pharmacists training 

Pharmacists need refresher training to conduct their duties effectively and against this background Centre for Social Concern and Development (CESOCODE) a MAMA member based in Malawi with funding from MAMA on granting conducted training for 20 pharmacists to equip them with accurate information on how to administer safe medical abortion in their pharmacies. Pharmacists need such refresher training sessions to sustain their knowledge and work effectively to administer safe medical abortion to clients in the community.

The training also provided accurate information and approaches that successfully improve pharmacists’ ability and willingness to administer safe medical abortions as well as referrals to other healthcare providers which will help women benefit from safe and effective medical abortions. Although pharmacists’ knowledge about medical abortion is limited, many are willing to provide medicine to help women with unwanted pregnancies. Women already seek medicines from pharmacists to end an unwanted pregnancy. 

After the training pharmacy workers showed more willingness to offer safe medical abortion services which will help to reduce cases of unsafe abortion among women and girls.

How is the media talking about abortion?

The way that abortion is portrayed in the media plays an important role in how people view abortions and can have a significant social and political impact. News coverage is one of the most powerful influences on public opinion, and, by extension, national and local policy agendas. By taking a closer look at how the media talks about abortion, The MAMA Network wanted to can get a better understanding of the language used, the ways that abortion is framed, and how it either contributes to abortion stigma or helps normalize abortion. Unfortunately, abortion is too often written about in the media in ways that are highly stigmatized, filled with inaccurate information, and framing it as a moral dilemma. Due to how little research has been done on how news outlets portray abortion, MAMA, along with several partners, set out to explore how the media in West Africa reports on abortion. We looked at 60 articles from media outlets across West Africa, published between 2015 and 2020, and here’s what we found. 

All articles had a clear stance on abortion – either the author(s) supported abortion rights and services or they opposed it. In articles that opposed abortion, journalists relied on heavily religious or moral language to make their argument, using words such as ‘scandalous’, ‘sin’, and ‘anti-biblical’, and described abortion seekers and people who perform abortions in negative ways. Articles against abortion were also filled with inaccurate information and misleading statistics. These articles drew heavily on the perspectives of religious officials and traditional community leaders and talked about abortion as a religious and moral problem. In some of these articles, journalists argued that abortion was against traditional values, and is a form of population control imposed by the West. Articles that pose abortion as a moral issue ignore the lived realities of people who have had abortions throughout history. People of all religions, ages, and cultures have abortions. These articles also fail to recognize that abortion is a central part of reproductive justice:  people’s right to choose to have children or not, to be supported in their decisions, and to parent in safe and sustainable environments. Abortion does not stand alone but is deeply connected to other issues, including poverty, migration, climate change, domestic violence, and so on.

On the contrary, publications that were supportive of abortion tended to use more academic language, referring to medicine, public health, and science. They drew their information from international scientific, research, or medical institutions, such as Guttmacher Institute and the World Health Organization. These articles used statistics and public health indicators to support their arguments and quoted both international and local health care professionals, researchers, and activists. These articles talked about abortion as a public health issue and discussed the importance of guaranteeing abortion as a human right.

The findings from this research tell us many things. The fact that we could only find 60 articles about abortion in a five-year period tells us that in general, there is very little coverage of abortion in the media. The little coverage that does exist continues to portray abortion as a highly polarised issue, perpetuating the idea that abortion is a matter of public and moral debate and not a necessary and common healthcare procedure and event in people’s lives. These articles dramatized abortion statistics, and in general used negative language to describe abortion, which in turn spreads fear and misunderstandings of the safety of abortion and the consequences of unsafe abortion. Furthermore, the voices and perspectives of people who have abortions continue to be left out of the conversation. In doing so, the media fails to show the diversity and nuance of abortion experiences and instead portrays abortion in simplistic and inaccurate ways.

The media plays an important role in disseminating information and shaping public views on abortion. So how can the media be better allies in the fight for abortion rights?

  • Frame abortion as normal part of our lives and health. This includes using evidence-based, up-to-date, accurate information from reliable sources.
  • Collaborations between the media and abortion advocates, in order to lift the voices of local experts and learn from each other.
  • Centre abortion seekers’ experiences and perspectives.Media coverage should reflect the complexities and diversity of abortion experiences, showing that abortion is a common experience and that there is no one single abortion story. This includes ensuring that there is representation of women and people who have abortions as the storytellers. We invite the media to become our allies in the fight for the destigmatisation and decriminalisation of abortion.
  • Combat misinformation. The media has a responsibility to provide factual, unbiased information. When it comes to abortion, that means ensuring that the language you use is clear and neutral, accurate, and non-judgemental. Ensure that the sources being used are reliable.

For more information on this research, please take a look at our full report.

The pandemic as a portal: Lessons from our research on COVID-19 impact

It is an understatement to say that COVID-19 has caused disruptions in our work and our lives.  Lockdowns, gathering restrictions, and a global shift in attention towards the pandemic has affected almost every aspect of society and has left other needs stranded. Abortion access, among other reproductive needs, has been sidelined and governments have failed to adopt measures to ensure continuity of services in the formal healthcare system.

Meanwhile, COVID-19 exacerbated the existing sexual and reproductive health needs that people had before the pandemic, such as the need for contraception, menstrual hygiene products, treatments for sexually transmitted infections, and abortion care. The government’s failure to ensure continued access to essential, time-sensitive medical care during the pandemic has caused interruptions to abortion services and aggravated longstanding barriers to safe and legal abortion. The barriers to abortion access affect all people, but disproportionately impact vulnerable groups, such as youth, sex workers, people with low income, and those living in rural areas. 

In 2020 the MAMA Network sought to understand and document the impact of the COVID-19 pandemic on the network’s member organizations and their work. The data from our study showed that many organizations’ budgets were not prepared to handle changes that COVID forced them to make. Additionally, physical distancing and gathering limitations downsized in-person activities. Working from home and decreased access to commodities also challenged organizations’ abilities to meet their intended programmatic goals.

Despite the growing need for abortion care, the pandemic saw a decrease in access. Many countries saw a decrease in the stock of abortion pills in pharmacies, healthcare facilities, and other suppliers. Many clinics that provide abortions closed due to the pandemic, and others considered abortion a ‘non-essential’ healthcare service and stopped accepting visits. Furthermore, people faced other challenges in accessing and taking abortion pills. Affording pills also became a problem, with many people losing economic security during the pandemic. It also became increasingly difficult for people to take abortion pills at home due to the lack of privacy that came with lockdowns, quarantine, and working from home.

Organizations and activists whose work is dedicated to expanding access to safe abortion services witnessed firsthand the effects of COVID-19 on the provision of abortion and faced new and unforeseeable challenges in meeting the needs of their community. Over the past year, MAMA Network has reached out to several of its members to better understand how organizations have been affected by the pandemic, and the ways they overcame challenges. 

One of the biggest challenges that organizations faced throughout the pandemic was the lack of funding. Many organizations’ budgets were not prepared to handle the changes that COVID-19 forced them to make, compounded by reduced funding from donors. The pandemic brought on new costs that had not been budgeted for, such as remote work costs, safety materials, and costs related to transitioning to online platforms. Many organizations also lost staff during the pandemic, mostly due to a lack of funding to pay salaries. Physical distancing and gathering restrictions highly impacted in-person activities. Organizations that conduct in-person outreach, such as workshops and community meetings, had to decrease the size of events or cancel altogether. Shifting to remote work also brought challenges, with many organizations lacking necessities required to work from homes, such as reliable internet access, computers and phones for home use, and the lack of privacy required to talk about abortion issues in countries where abortion is legally restrictive and stigmatized. 

Notwithstanding these challenges, activists developed creative and resourceful ways to continue their work and ensure continued access to abortion information and services. Organizations adapted their activities to meet COVID-19 safety guidelines, by providing personal safety equipment, implementing physical distancing, limiting the size of gatherings, providing one-on-one appoints, and doing outreach, and were thus able to resume their in-person visits and provide abortion support. Many organizations moved their programming and activities to online spaces when the pandemic hit. Organizations improved their websites, used social media to advertise their services, and utilized online chat platforms to provide information. Hotlines became a critical resource for safe abortion and sexual health information during the pandemic. Many organizations took the opportunity to turn their efforts inwards, by focusing on training staff and increasing their operational capacity. 

However, our report shows that despite all the efforts done to overcome the challenges brought on during the pandemic, there is no amount of resilience that can trumple the lack of structural change that is needed. For many organizations that are members of the MAMA Network, lack of funding and restrictive budgets have been one of the biggest hurdles to continuing work throughout the pandemic. Such limited funding prevents organizations from implementing solutions to unforeseen challenges and stifles opportunities for creativity and innovation. Activists on the ground are best suited to recognize the needs of their communities, and find solutions to meet those needs, and should thus be granted the trust and autonomy to do the work in the way they see fit. 

Inspired by Arundhati Roy we believe that the pandemic is indeed a portal and we are ready to imagine a new world and fight for it.

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.