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Translating Research into Policy Advocacy in Nepal

Translating Research into Policy Advocacy in Nepal. Public Education and Advocacy Against Unsafe Abortion. Anand Tamang CREHPA. ISSUES CONCERNING ABORTIONS. Nepal has one of the highest maternal mortality (539 per 100,000 live births).

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Translating Research into Policy Advocacy in Nepal

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  1. Translating Research into Policy Advocacy in Nepal Public Education and Advocacy Against Unsafe Abortion Anand Tamang CREHPA

  2. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion ISSUES CONCERNING ABORTIONS • Nepal has one of the highest maternal mortality (539 per 100,000 live births). • Over half of the maternal deaths are due to unsafe abortions. • Induced abortion is a criminal act in any circumstances, even in case of rape or incest. • Both women and service providers are punishable by imprisonment

  3. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion ISSUES CONCERNING ABORTIONS (Contd…) • Despite legal restrictions, every year thousands of induced abortions are performed illegally. • Nepal is the probably the only country in the world where women are incarcerated for abortion • Prevention and Management of complications of abortions is one of the eight components of National RH Strategy 1998 of Ministry of Health/Nepal

  4. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion RESEARCH ON ABORTIONS Between 1991-2000, a number of abortion related research conducted and their results disseminated by CREHPA: 1. Determinants of Abortion and Subsequent Reproductive Behavior Among Women of Three Urban Districts of Nepal 1991-94 (Tamang, et al , IIDS) 2. Opinion Polls on Abortion Rights for Women. 1996 3. Induced Abortions and Subsequent Reproductive Behavior among Women in Urban Areas of Nepal, Nov. 1996 (Published paper)

  5. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion RESEARCH ON ABORTIONS (Contd..) 4. Factors Behind Women’s Imprisonment in Nepal with Special Reference to Women Imprisoned for Abortion, Sept. 1997-98 5. A Study on Implications of Restrictive Abortion Law on Women's Social Status and Health 1998 (Published Paper and Advocacy Paper in Nepali) 6. Knowledge and Perception of Rural Married Women on Abortions in Seven districts of Nepal. 1999 7. Perceptions on Safe & Unsafe abortions among frontline health providers and village opinion leaders in Eastern Development Region of Nepal. 1999

  6. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion RESEARCH ON ABORTIONS (Contd..) 8. Management of abortion related complication in hospitals of Nepal: A Situation Analysis. 2000 9. Unwanted Pregnancy, Sex Determination Tests and Abortion Seeking Behavior in Private Clinics of Nepal. 2000 10. Extent of Contraceptive Failure, Unwanted Pregnancy and Induced Abortions Among Married Couples in Kathmandu Valley. 2000 (Analysis on Progress) 11. Role of Private Pharmacist in Preventing Pregnancy related Complication Including Unsafe Abortions. 2000 (Analysis on Progress)

  7. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion KEY ISSUES EMERGED FROM RESEARCH • The large majority of the women are unaware of the legal status of abortion • The 1997 nationwide prison survey reveals that 80 women (20%) as against 14 men were imprisoned for charges of abortion or infanticide (CREHPA, 2000). • 20% and 60% of all obs & gyne admissions in six major hospitals are abortion complication cases.

  8. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion KEY ISSUES EMERGED FROM RESEARCH (Contd…) • Women with abortion complications occupy hospital beds for about 3 days to over 7 days and spend on an average Rs. 3,918 for treatment. • Most women resorting to unsafe abortion procedures were unaware about the possible health risks of the act. • Majority of the government hospitals lack sufficient manpower, equipment, space, beds, etc., to deal with abortion related complications.

  9. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion FELT NEEDS • Advocacy for Legalizing abortion • Education about health implications of Unsafe abortions • Enhancement of providers' skills and services at government hospitals to deal with abortion complications • Discouragement of abortion services by Unqualified persons • Periodic updates of abortion data

  10. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion STRATEGIES DESIGN & NETWORKING Planning and strategies development workshop organized in October 1998 to initiate PUBLIC EDUCATION AND ADVOCACY PROGRAM (PEAP) Purpose: • To develop appropriate advocacy messages and slogan • To develop logo for PEAP • To develop non-threatening messages • To identify the medium for disseminating advocacy messages • Networking with Ministry of Health (MOH)

  11. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion STRATEGIES DESIGN & NETWORKING (Contd…) • To identify and analyze strengths and weakness of district level NGOs and explore the ways and means of empowering them under PEAP • To plan appropriate supervision and monitoring mechanism for PEAP • To prepare suitable strategies for reopening policy dialogue with law makers at district and central levels

  12. SituationAnalysis Strategies PEAP Mobilization Continuity/ Expansion Action Evaluation Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion THE FRAMEWORK

  13. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion ACTION : Slogans & Text Messages Developed Appropriate non threatening advocacy messages and slogans developed in Nepali: "Do not rely on unqualified Persons Do not resort to unsafe abortions" "Unsafe abortions can claim women's lives Abortion is not a method of family planning" "Unsafe Abortion may put women's lives at risk". "Healthy life of mother and child, Use methods of family planning, Avoid Unsafe Abortions"

  14. Communication & Dissemination Media Community Electronic Press Printed - Posters - Brochures - Banners - Policy Briefs - Advocacy Papers - Photo story - Articles - Advertisement - Press Conference - Journalists Forum - Radio Program - Web-site - Advocacy workshops - Educational Workshop - Street Drama - NGO Empowerment Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion ACTION: Medium of Communication & Dissemination Identified

  15. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion ADVOCACY STRATEGIES: Media Coverage

  16. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion Target Audience for PEAP Education - Women Groups - Social Workers - Community Health Providers - Pharmacists - Community Leaders - School Teachers / High School Students Advocacy - Parliamentarians - Political Parties - Policy Makers/ Administrators - Lawyers - Women Associations - Journalists - NGO/INGOs

  17. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion ACTION: MOH Involved From the Start • Technical advisory committee with representatives from NHEICC/MOH formed for IEC development • Formal launching of the posters and brochures by representatives from NHEICC/MOH

  18. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion ACTION & OUTCOMES OF PEAP-I • More District level NGOs identified and trained • District level advocacy workshop held by partner NGOs • Village level PEAP activities launched by partner NGOs • Demand created for replication of the program • Formation of Network : SMHEAN (Safe Maternal Health Education and Advocacy Network)

  19. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion INFLUENCING POLICY • Acceptance and ownership of the IEC materials (Posters) on abortions by MOH • Inclusion of PEAP related strategies in government's 15 years health plan • District Health office (MOH) demand orientation training for TBAs against unsafe abortions • Formation of seven member committee (with the inclusion of CREHPA) by MOH for advocacy towards legalization of abortion (submission of a separate abortion bill by MOH)

  20. Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion LESSONS • Research is key to influence Opinion & Policy. • Since abortion is highly divisive issue, sensitization should start from the top. • Wide range of Approaches needed. • Cost-effective yet expensive • Concerned Policy Makers' involvement required from planning stage • Credibility of the organization • Creativity & Continuity Necessary

  21. NEPAL Translating Research into Policy AdvocacyPublic Education and Advocacy Against Unsafe Abortion Thank You University of Southampton & John Snow International, UK

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