Abortion in French-speaking Africa: feminist movements on the front line

Essential human rights, SRHR are a major component of the fight against gender inequalities and contribute to progress towards fair and sustainable development. They form a continuum of indivisible rights and care. Abortion is a key component, which should no longer be neglected. At a time when Benin has just enacted one of the most progressive laws in favor of access to abortion in Africa, nearly 92% of African women still live in a country where abortion is illegal. . Even when abortion is permitted in cases of rape, incest or to save a woman's life, stigma, discrimination and lack of information mean that women continue to have recourse to abortions very often. insecure at the cost of their health and their lives. The figures remain edifying: 15,000 avoidable deaths each year! Access to abortion is a matter of public health as much as of women's rights.

The Ouagadougou Partnership, a promising initiative

This multi-stakeholder initiative has made family planning in West Africa its priority with the initial objective of reaching “6.5 million additional users of modern methods of contraception by 2030”. When the Ouagadougou Partnership (PO) was created, it was not possible to put the issue of abortion on the discussion agenda. There are several reasons for this, including the “Global Gag Rule” reinstated in 2017 by the Trump administration, which deprives institutions that refuse to sign it of essential funds for health services such as contraception, prevention and treatment. treatment of STIs and HIV. The PO receives support from bilateral development agencies, private foundations, which has generated high international visibility and government commitments on the subject. This has undeniably led to progress in family planning. But this mobilization cannot achieve its results if abortion continues to be excluded from discussions. Contraception and abortion are facets of the same coin: the right to freely dispose of one's body. To sustainably advance access to care, it is necessary to promote full application of the concept of SRHR (as defined by the Guttmacher-Lancet Commission), without limiting it to questions of contraception. safe abortion services and post-abortion care, action must be taken at all levels of the sustainable abortion ecosystem and therefore on the factors that hinder women in their choices to terminate a pregnancy: social norms , community support, legislative and regulatory frameworks, financing, availability of inputs.

Mobilization of civil society for the right and access to safe abortion

Many associations have long advocated access to abortion as part of the overall continuum of SRHR. Thus, on the sidelines of a meeting of the PO in 2018, they met to coordinate and join forces. Their goal? To speak out for safe abortion in French-speaking Africa, to call for the urgency of reinventing partnerships, far from the usual divisions that oppose civil society and government, providers and communities, to break the taboos surrounding abortion, causing the death of thousands of women each year.

3 years later, the ODAS center was born: Organization for Dialogue for Safe Abortion in Francophone Africa, the first regional institution dedicated solely to the defense of the right to abortion. The DSSR will only be effective with the involvement of women, so they occupy a central and decision-making place within this institution initially “incubated” by the Ipas organization. ODAS aims to give effect to the provisions of the Maputo Protocol; main instrument for defending the rights of women and girls in Africa. It is a unique instrument in that it guarantees abortion in the event of rape, incest, fetal malformation or danger to the health of the mother. 42 States have ratified this protocol to date and have the obligation to translate these provisions into their public health policies. But in recent years, we have seen ever stronger opposition to sexual and reproductive rights in multilateral bodies, due to the rise of "anti-gender" and anti-choice movements, but also to the historic marginalization of abortion in the within the United Nations. In response, an African feminist mobilization is making itself heard and is demanding in particular the application of regional texts on human rights, including the Maputo Protocol. The latter has probably contributed over the past 20 years to the relaxation of abortion laws in 21 countries, including the Democratic Republic of Congo in 2018.

For a full realization of the fundamental rights of women and their empowerment, the PO and its partners must grasp the issue of safe and legal abortion. ODAS and its allies are there to promote a rights-based approach, put women and feminist associations at the heart of these demands, strengthen partnerships with grassroots associations, midwives, young people: the fight for DSSR will either be inclusive or it won't.

Abortion: a harm reduction approach for Médecins du Monde in the Democratic Republic of Congo

In Kinshasa, nearly 60% of pregnancies are unwanted, more than 30% end in unsafe abortions, responsible for nearly 20% of maternal mortality. Since November 2018, Médecins du Monde (MdM) has developed, in collaboration with the Congolese Ministry of Health, and via funding from the Packard Foundation, a harm reduction (RdR) approach providing a response to requests for abortions. A referral network was created around three main actors: community workers, health centers and pharmacists, all trained in values ​​clarification on abortion and the HR approach. Through this, women and girls wishing to have an abortion receive quality, non-judgmental information on the use of misoprostol. To date, 1,300 women have benefited from complete abortion care, no major complications have been recorded, more than 85% have benefited from post-abortion contraception. This project is built around a strong community approach and also feeds advocacy for the application of the Maputo Protocol and, more broadly, for the removal of legal barriers to abortion.

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