Access to Emergency Contraception and Safe Abortion Services for Survivors of Rape: A Review of Policies, Programmes and Country Experiences in Sub-Saharan Africa

Posted by Share-Net NL on May 28, 2015 at 5:58 am



Executive Summary: This study examined how pregnancy prevention and management services (specifically, the provision of emergency contraception, pregnancy testing and counselling, and termination or referral for termination of pregnancy services) feature within post-rape care (PRC) services in sub-Saharan Africa. Guidance provided by the World Health Organisation was used as a benchmark for examining these issues. The study drew on a range of sources via a desk review, as well as on information provided through key informant interviews.
Several key messages emerge from the study’s overall findings:
1. National PRC guidelines consistently identify pregnancy prevention as an essential element of sexual assault management and all include provisions on emergency contraception for eligible survivors. Nonetheless, the study reveals a disconnect between PRC guidelines and guidelines for reproductive health/family planning, with the latter less likely to address the specific needs of rape survivors although many contain general provisions on emergency contraception.
2. Pregnancy management and safe abortion for survivors do not feature prominently in national sexual violence guidelines in the region, with only a few exceptions. Existing provisions for pregnancy management and abortion also tend to lack detailed guidance or country-specific information that would facilitate access to these services. Pregnancy counseling is unevenly addressed across the national protocols examined.

3. Of the eight national protocols reviewed, only three treat safe abortion as an essential element of care to be provided for rape survivors, with clear guidance on its provision. The existence of numerous national guidelines in the region demonstrates countries’ desire to respond to this public health and legal challenge. However, if left in their current state, the gaps and inconsistencies observed across most national guidelines contribute to a violation of survivors’ rights and of good medical practice as outlined in international protocols. In conclusion, countries in the Sub-Saharan Africa region would benefit from intensive support to update and consolidate guidance on these critical issues.

The recommendations arising from this study are outlined below:
– Engage regional bodies mandated to foster regional cooperation in health to communicate these findings so that they can facilitate harmonisation and adherence to regional and international standards of care for rape survivors.
– Support regional bodies to develop prototype guidance that can be adapted by countries throughout the region.
– Convene regional workshops to promote and support the updating and consolidation of national guidance by countries, including the medical sector, the judiciary and civil society to enhance alignment of health system policies with national laws and rights commitments.
– Popularise revised national protocols among health providers and the police, including integration into medical and legal training curricula, and among the general public to heighten awareness of the rights of survivors to such services.

http://www.raiseinitiative.org/library/search.php?search_id=1141

Author: Thompson, Jill
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