Maternal health
Changing Policy and Practice
Access to contraceptive and abortion services can vary from country-to-country depending on laws, local knowledge, and service provision.
With funding from the Medical Research Council (MRC), Professor Ernestina Coast and her team have explored how adolescent access to contraception and abortion-related care is perceived and experienced by adolescents in urban Ethiopia, Malawi and Zambia. Contraceptive and abortion service barriers are high and even small challenges can be huge for adolescents. Seeking an abortion in a facility, or care for complications due to a less safe abortion, is influenced by the legal and service provision setting. In Ethiopia safe abortion services are freely available for adolescents and widely available in the public health sector. However, many Ethiopian adolescents experienced multiple delays at facilities. In Malawi a highly restrictive abortion law combined with very limited service availability means most adolescent abortions are unsafe. In Zambia despite longstanding legal grounds for abortion, there is low knowledge of the law and patchy service availability.
Using their research findings, the team have developed country-specific animations for adolescents providing tailored information on abortion relate -care. With the Foundation's support, they will launch a multi-pronged and multi-country social media campaign with the support of a specialist communications expert. They hope this campaign will get the team's social media products into the hands of adolescents in these countries.
The team also found that healthcare provider tensions and misunderstandings about adolescent policies and needs (e.g. parental consent) sometimes resulted in coercive care. Professor Coast will design a virtual-short course that targets healthcare workers and students about adolescent-centred abortion-related care. The team plan to maximise the impact of this work by engaging NGO and Ministry of Health officials in its rollout.
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