RHM has endorsed a statement by IPAS calling for the Zero Draft Global Strategy for Women’s, Children’s and Adolescent’s Health to explicitly identify safe abortion as a component of the strategy. The document is open to stakeholder input until June 5th 2015. If you and your organisation would like to endorse the following statement please send an email to IPAS by June 1st 2015
Joint statement on the importance of including safe and legal abortion as a key approach in Round 2 of the Global Strategy for Women’s, Children’s and Adolescents’ Health
The May 5th zero draft of the Global Strategy for Women’s, Children’s and Adolescents’ Health reflects important areas of emphasis for achieving the Sustainable Development Goals. The call for transformative change, the use of a rights-based, equitable approach, the focus on overall health systems strengthening and multi-sectoral collaboration, the attention to the needs of adolescents and fragile settings are all commendable. Importantly, the document acknowledges that the strategy builds on commitments from the ICPD Programme of Action and the Beijing Platform of Action and references the Sexual, Reproductive, Maternal, Newborn, Child and Adolescent Health (SRMNCAH) framework. However, the failure to explicitly identify safe and legal abortion in the document is a significant, glaring gap.
Unsafe abortion remains a major and preventable cause of maternal death and illness worldwide, and overwhelmingly in the developing world. The World Health Organization and the Partnership for Maternal, Newborn and Child Health have identified safe abortion as an evidence-based strategy for reducing maternal deaths. The independent Expert Review Group (iERG), in the first summary of progress on the current Global Strategy for Women’s and Children’s Health, identified the “pervasive neglect of safe abortion services” and added, “the evidence is overwhelming: Every Woman, Every Child will not be fully delivered unless the huge burden of unsafe abortion is confronted by public health strategies of harm reduction – namely, the provision of family planning and safe abortion services.”
Fundamentally, a strategy designed to reduce preventable, maternal deaths must include safe and legal abortion. Abortion is legal in almost every country in the world at least to save the life of the woman. Many countries provide additional indications for legal abortion in cases of rape, incest, the health of the woman and broader circumstances. To not explicitly include safe and legal abortion as an integral part of this strategic guidance perpetuates denial of women’s human rights and sends the message that the strategy serves every woman, every adolescent and every child, except those in need of abortion care.
There are many opportunities throughout the document to address this gap. At a minimum, we call for this change to the Zero Draft strategy in Figure 7 — Essential health interventions for women, children and adolescents, at critical stages in the life course, with appropriate references:
Under the Pregnancy column:
- Add safe and legal abortion and postabortion contraception to the Referral level and First level facility.
- Add awareness and referral for safe and legal abortion to the Community level.
The Zero Draft strategy claims “we know what works and what still needs to be done. Now, under the Sustainable Development Goals (SDGs), we have the opportunity and the responsibility to further transform the way we work in the period from 2016 to 2030, so that we create the conditions for a healthy, prosperous, sustainable future for every person, everywhere.” We cannot make this claim if we selectively exclude women in need of abortion when we know that safe and legal abortion is an evidence-based strategy for success.
We know that ensuring access to safe and legal abortion works not only for women, but also affects the health and well-being of their children and families, and we urge the inclusion of this important component of women’s health in the final strategy.
World Health Organization. 2012. Safe abortion: Technical and policy guidance for health systems. Second edition. Geneva, Switzerland: WHO.
The Partnership for Maternal, Newborn & Child Health. 2011. A Global Review of the Key Interventions Related to Reproductive, Maternal, Newborn and Child Health (RMNCH). Geneva, Switzerland: PMNCH.
World Health Organization. 2014. A Policy Guide for Implementing Essential Interventions for Reproductive, Maternal, Newborn and Child Health (RMNCH). Geneva, Switzerland: WHO.
independent Expert Review Group. 2012. Every Woman, Every Child: from commitments to action. The First Report of the independent Expert Review Group (iERG) on Information and Accountability for Women’s and Children’s Health. Geneva, Switzerland: World Health Organization.