You are browsing the archive for Tanzania.

The Power of Pills: Putting Abortion Back in the Hands of Women Around the World

4:02 pm in Uncategorized by RH Reality Check

Written by Leila Hessini and Alyson Hyman for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

A collection of different pills

As governments force clinics out of business, pill-based abortions offer freedom of choice to women.

Unwanted pregnancies are a fact of life. Globally, nearly a fourth of all pregnancies are unplanned and 22 percent of pregnancies end in abortion. Women experience unwanted pregnancies because they have forced sex, (worldwide, one in three women are survivors of sexual violence), they don’t have access to contraceptives, or they simply didn’t plan on becoming pregnant.

Women who have unwanted pregnancies should be respected and their rights to choice upheld. However, in many countries, government policies, and societal practices do not uphold women’s right not to continue a pregnancy and women with unwanted pregnancies are forced into motherhood. Certainly this is evident in the United States; just before the new year, the governor of Virginia quietly signed legislation designed to close abortion clinics in the state. These laws are punitive, restricting women’s reproductive autonomy and freedom and creating categories of who can and can’t obtain abortions.

Fortunately for women, pills have changed the landscape of abortion. Abortion with pills, also known as medical abortion (MA), provides a safe, low-cost and easy to use method to terminate pregnancies. In addition to being safe and effective, medical abortion has changed the dynamics of who can provide abortions, where women get them, and who has control over the process. Evidence shows that those closest to women — community health workers and midwives — and women themselves can be trained to use abortion pills to safely terminate a pregnancy, thus giving women back the control of their own bodies. In fact, it was women in Brazil who first discovered the potential of misoprostol (cytotec) to safely end an unwanted pregnancy and who shared this knowledge through their social networks.

In order for women to benefit from the potential of medical abortion, however, they must be active participants in decisions related to where drugs are distributed and for what cost, what information is shared and by whom, and what social and medical support is needed.

Last month, Ipas hosted a meeting — “In Women’s Hands: Increasing Access to Medical Abortion Drugs and Information through Pharmacies and Drug Sellers” — in Nairobi, Kenya, that brought together 66 participants from 11 countries to discuss these important issues. Participants included a Kenyan hotline program manager, president of the Ugandan Midwives Association, several pharmacy managers from South Africa, and a Nepali senior public health officer in the Ministry of Health and Population, to name a few. The broad swath of countries and professionals represented illustrates commitment to a movement — to give women control of their reproductive lives, particularly through abortion with pills. In different countries, women, advocates and providers have developed innovative strategies to meet this goal.

In Tanzania, the Women’s Promotion Centre founded its own small pharmacy in a rural community as an alternative model for supporting women’s access to safe motherhood and abortion. This effort was born out of the “fire of anger about unnecessary deaths and suffering of women and… passion to save mothers’ lives in Kigoma,” said Martha Jerome of the Centre. Because no pharmacies were selling the lifesaving drug misoprostol, they founded a pharmacy to provide the drug themselves. They trained staff to provide counseling and support and they formed an alliance with like-minded doctors to help women with any complications. They also supply contraceptives as well as other medicines. The competition that resulted from their lower prices has driven down the cost from other private drug sellers, making these medicines more affordable for women who need them.

Read the rest of this entry →

Forced Pregnancy Testing: Blatant Discrimination and a Gross Violation of Human Rights

10:38 am in Uncategorized by RH Reality Check

Written by Onyema Afulukwe for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Earlier this month, news spread of a Louisiana charter school’s policy that would have allowed faculty to force any student suspected of being pregnant to take a pregnancy test — and, if the test came back positive, to force her to go on home study.

Forced pregnancy testing in schools is a gross violation of young women’s fundamental human rights. Through legal advocacy, I have been working to get it recognized as such and outlawed — in Tanzania, Kenya, Uganda, in my home country of Nigeria, and in other countries in the African region where it occurs. It is a shock to see a practice I’ve come to associate with schools in the developing world being replicated in the United States.

I have seen the consequences firsthand, and they are devastating. In secondary school, the older sister of a classmate, who was a year ahead of us, was found to be pregnant and expelled by school administrators. We eventually learned that she was the victim of a rape which occurred in her home, but she was too terrified to tell anyone what had happened. As is the case with many victims of this injustice, no other schools would accept her. Her hopes for a better future were doomed.

In Tanzania, where nearly 44 percent of girls have either given birth or are pregnant by the age of 19, school administrators across the country force schoolgirls to undergo demeaning pregnancy tests often just before completing primary school — around the age of 11 — and with increasing, and random, frequency throughout secondary school. Some girls must strip to their underwear to reveal physical signs of pregnancy. Others are coerced into taking urine-based pregnancy tests. No one can refuse to be examined or tested.

The impact is staggering, long-lasting, and far-reaching. About 8,000 girls are expelled or drop out because of pregnancy in Tanzania every year. Too often families abandon their pregnant teen daughters, forcing them to live on the streets with their babies. Faced with the possibility of homelessness, some young women succumb to pressure from their families to seek financial support through early or arranged marriages. The impact of these violations to their rights to health, education, privacy, and freedom from discrimination ripples throughout young women’s lives. Many female leaders of human rights advocacy groups still remember, over twenty years later, how humiliating and disempowering it was to experience forced testing even though they did not turn out to be pregnant.

Government officials do next to nothing to improve the situation despite its epidemic proportions; nearly 60 percent of the country’s adolescents have sex before 18. And in a double standard that’s all too common in many places throughout the world, while young women are stigmatized and penalized for pregnancy, the men and boys involved are rarely identified and face few consequences for their role.

In the United States, the reaction to the news about the Louisiana charter school was swift. Under threat of a lawsuit by the ACLU, the school reversed course and amended its student pregnancy policy, which no longer includes the invasive forced pregnancy testing it initially announced. The revised policy now assures female students the opportunity to continue schooling on campus throughout pregnancy and the option for homeschooling. This is a just and appropriate result.

Nevertheless, the emergence of this idea in an American school should trouble anyone concerned with the protection of our fundamental constitutional and human rights. And it should serve as a reminder of the importance of guarding vigilantly against violations of these rights not just in the developing world, but also — sadly, it seems — in the U.S.