Working Together Towards Global Safe Abortion- 3rd IWAC

The conference is an international platform for global exchange, updates and sharing information on safe abortion as well as providing networking opportunities among committed health workers and SRHR safe abortion advocates. The theme of this congress was “Working together Towards Global Safe Abortion” recognizing that unsafe abortion still kills and disables thousands of women worldwide every day.   Highlights of the conference:

1. Conscientious objection: service providers should not deny the women access to abortion. (raised by Jon O’Brien and Dr. Choong from Malaysia).

2. Values clarification should be mainstreamed within medical education curriculum: To help future service providers understanding of the importance of women’s access to safe and legal abortion services and to enhance the quality service, non-judgmental service and maintaining privacy and confidentiality of clients.

3. “Trust Women”: The key to good medical abortion services (by Beverly Winikoff, Gynuity Health Projects.  

I came across the terminology “Conscientious Objection” during the refresher training organized for youth champions who had attended Youth Advocacy Institute organized by Asia Safe Abortion Partnership in 2014. Dr. sim-Poney Choong, Co-Chair, Reproductive Rights Advocacy Alliance Malaysia and a founder of Asia Safe Abortion Partnership said that it is a duty of a service provider to serve its client with non-judgmental attitude. He/she is not in the state of denial of service to its client because of his/her beliefs. If service providers do not perform abortion to a woman who needs, because it is against his/her beliefs then he/she is in wrong profession. Service providers before joining their profession as doctors or nurses take oath to serve every client. If they don’t, they are the reason for women seeking unsafe and illegal abortion resulting into complications and even death of women.

 Dr. Amar Jesani of the International Medical Journal of Ethics talked about abortion and how to handle ethical questions at Youth Advocacy Institute.

I agree that people come from different backgrounds and they have their own values and norms. However, when you serve nation as service provider on women’s health the important value is saving women’s lives rather objecting abortion service to them because it comes against own values. The best solution for this could be integrating Value Clarification Activities during the training for service providers on abortion. This helps to clear their values.

There was a presentation on trusting women by Beverly Winikoff- Gyunity Health Projects who talked about George Tiller, an American physician, an abortion provider and martyr for women’s right to choose. His motto was, ‘TRUST WOMEN’, an exhortation meant as moral and philosophical. It turns out that it is also very good policy and clinical advice. Her presentation spoke about medical abortion that has been made easier and more acceptable if women are included as major actors in the process and how many aspects of medical abortion treatment can be delegated directly to the woman with no loss of efficacy, safety or acceptability. Indeed, such a revamping of services seems to be more acceptable and preferable to many women.

An examination of what is required of medical abortion services using this lens raises the question of why the drugs are so often restricted to specialist services and to provision in clinics or hospitals only. Why shouldn’t medications for abortion be provided in pharmacies, like other safe and effective medicines? And why shouldn’t they be prescribed at the lowest level of the health care system that can use them effectively and safely- maybe by women themselves? This emphasized on trusting women and empowering them with information and self administrating the medical abortion pills.

Another interesting session was by Dr. Christian Fiala, MD, PhD Spezialist in Obstetrics and Gynaecology shouted asking question Why Is Abortion Illegal? What were the considerations and the intention of making it illegal in the first place? He, then clear the answer saying: monarchies, dictatorships and war leading countries wanted to increase their population and to have more soldiers. Care of children or women has never been a thought. It was only with democratic developments that people too, the freedom to vote for their political representatives and also wanted self-determination in the most intimate aspects of life: one’s sexuality and fertility. He also presented that respecting women implies to give the power to decide over all aspects of their reproductive choices. It also implies the duty for societies to rid of all remaining obstacles and patronizing restrictions.

Body Shamming Culture 

IMG_1095Body shamming is not the one opt from anywhere. It’s in our culture. Born with dark skin is a kind of embarrassment to your family and yourself of body shamming culture in your society. There is not anything which says body shamming culture but you face it each and every time you hit the street, events and mostly more in family functions. Did you ever stop and think about how often we are told to change our appearance? Magazines constantly offer tips about how to lose weight “in days,” appear slimmer “instantly,” and hide our “imperfections”… without actually knowing anything about us, much less our appearance. This is one example of body-shaming, and it is everywhere.

 I still remember my childhood and my relatives called me “Kali”. This means girl with dark skin. The motivated part of it is you resemble to the GODDESS KALI. In my school days, I had a teacher with dark skin. My friends used to tease me being darker in skin ton than theirs. My teacher heard about that and he said, “at least we are born with color”. WOW….. after this I started to compare myself with Goddess Kali and her daring stories of bravery. It actually did not matter to me as my mother told me I got the skin color from my grandmother. What else I expect than this… as I am compared to KALI and my Grandmother. But each time Someone commented on my skin color I hide on my mother’s lab and she always convinced me with various reasons which indeed inspired me. This meant I always need reason to face criticism. It was hard sometime. The best part is I learnt to face these criticism whether it on my skin color, my weight and my height. I love my body image.

 Due to body shaming culture, I have been skipping family functions. It’s really disturbing when your relatives come to and instead of asking about your education and career, they jumped on your body weight and prohibit you to eat. They never share what could be the best solution to get rid of fat in the body but they tease you with satires. The most popular one is “oh your weight; you won’t get good marriage proposal” & ” boys like skinny girls rather than heavy weight”.

Your Reflection Does not Define Your Worth

No matter how body shamming manifests like criticizing your own appearance, through a judgment or comparison to another person (I’m so ugly compared to her), it often leads to comparison and shame, and perpetuates the idea that people should be judged mainly for their physical features.

 These days, beginning with puberty, females are TWICE as likely to experience depression as males. This is directly associated with our objectifying culture, which leads us to evaluate and control our bodies in terms of our sexual desirability above all else. Similarly, media has been dangerously sexualizing women and girls and it has given the false impression that to be attractive, popular and interesting you must be skinny and hyper-feminine. Globally there is a body acceptance movement today which attempts to combat the negative stereotypes around women and men who are conventionally considered overweight or obese. Body shamming is now a culture which has been in grained in our system that the coming generations are prone to risk behavior. Instead of body shamming we should accept the culture of respecting and communicating about loving ones body.

Replace judgement and criticism with love

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My life At 15

I am born in a middle class family with good reputation and environment. My parents are educated and they are well known in the society. The priority of my childhood was to complete my schooling. Well there has been always a pressure on me and my cousins to score good marks and always be within top 5 in the class. I was in grade 9 when I was just 15. I was messing with my study and my physical changes. I hated going school in my periods. In my fifteen, none shared me that periods are normal and its natural. Nobody empowered me saying it is indeed good to bleed which symbolizes that I am fertile and I am able to give birth to new ones. I felt really embarrassed whenever I had my periods. I stopped playing with my male cousins and stopped siting in same bench with my male friends. I was juggling with my bodily changes and the societial norms. In school I was learning son and daughter are equal, I found its different in my family and surroundings.

In my fifteen I was suggested to join school scout by my principal but my mother denied. She said to become a Girl Scout I need physical strength which she thought I lacked. I had interest in sports. My dad indeed was the best football player in his time. He wanted a son with whom he could fulfill his dream to become national football player. Although he never showed that he actually wanted a son, he supported me to participate in sports. In my fifteen, I joined my school’s basketball team. We were trained for few months and we discontinued with the reason that we had to attempt School Leaving Certificate examination which means a lot. SLC exam was seen as iron gate and my family + my school had great expectation from me to score atleast 80% as they wanted me to join medical line in the future.  

 Even though my family is educated, it is influenced by societial norms and values. It’s a patriarchal community where daughters are believed as the responsibility of parents; to be married off in time. While I was studying in my fifteen, there were my relatives who were eager to fix my marriage. In my fifteen I got my first marriage proposal. I still remember it was winter and it was on holiday when my cousins started giggle. I asked them what’s the matter. They didn’t share instead laughed at me singing songs. My mom didn’t share this to me but my grand mom did. I didn’t know how to react. Is that a good news for me? Should I be happy? Mixed feeling. But my parents were against getting me married in my teen. They said they wanted me to complete my higher education, get job and decide what I wanted in my life. Although my parents stood for me people in my society did not digest that I should take my own decision to decide when, where and with whom I should get married. 

  I would like to thank my parents for standing with me. If they had not decided about my future to independence, I guess today I would have been mother of two children depending totally on my husband and getting drepressed of my life. Today I am a youth activists advocating for young girls and women for their right to access information and services to sexual and reproductive health. I have never regret of being girl. But the story is not similar to other girls. Girls in Nepal are deprived of education, information and health services. 

Today world celebrated International Day for Girl Child. In Nepal 17 percent of girls become pregnant or mothers for the first time as early as at the ages between 15 and 19 and almost 83 percent adolescents of the same age group lack access to modern contraceptives in Nepal. As a result of early and frequent pregnancies, many women and adolescent girls are undergoing sexual and reproductive health problems. Nepal comes to top 10 position among countries in the world and ranks third in South Asia with the highest child marriage rate.

 Stakeholders have said that rampant child marriage is the root cause of many problems such as gender-based violence, reproductive health troubles and school dropout, among others. As a result of rampant child marriage in Nepal, health of both women and girls is at risk.

The data of Nepal Demographic and Health Survey (NDHS), 2011, even suggests only 38 percent of women in Nepal know that abortion is legalized in the country and seven percent of maternal mortality is due to unsafe abortion. Nepal had legalized abortion on September 26, 2002.

So there are unfinished business when it comes to ensuring sexual and reproductive right of girls. Our society must realize that girls are not brides. Gender equality with equity should be ensure for girl. Girls should not hate themselves for being girls. The stereotypical concept of gender should be totally ignored and empower girls in education, sports, technology to achieve national health objectives.  

 

Media Sensitization on Safe Abortion

Youth Champion Advocacy Network Nepal, YOUTHCANN had received a small grant from Asia Safe Abortion Partnership to organize various advocacy session on safe abortion to different groups like young people, service providers and media people. On the occasion of September 28, Global Day of Action for Access to Safe and Legal Abortion, YOUTHCANN organized half day sensitization program on safe abortion to media persons from print and radio.

Media is one of the most powerful instruments of communication. It plays a very constructive role in today’s world. As we know media plays an important role in increasing of public awareness and collect the views, information and attitudes toward certain issues. It presents the real stage of society. Without the media, people would be isolated, not only from the rest of the world, but also for the total formation of creditable world.

The media has got a vital role in molding positive perspective on abortion among people and spread positive message in the society to #BustTheMyths. But there is a myths on media

Myths: Most Media People Object the Abortion.

Facts: Media People are Often leading Advocates for Safe & Legal Abortion

Resource person Ms. Madhabi Bajracharya from Ipas shared that Ipas Nepal also closely works with media people and organize sensitization program for them regarding abortion. It has been observed that media people have their own values and they rarely accept abortion a woman’s right. Holding ones values on abortion might give rise to bias news and information which simultaneously lead to #abortionstigma and discrimination.

Likewise, one of the Youth Champions shared that she has been following various articles been published in newspaper and online news regarding abortion, the media always covers news on women deaths and complication due to abortion but they never specify where the deaths and complications are due to safe or unsafe abortion. There is difference between safe or unsafe abortion and reporting accordingly.

LM-abortionStigmaSP-info3-130915_02-1024x1024There was very good discussion among participants and facilitators. One of the media person asked what YOUTHCANN is doing to avoid abortion? Avoid Abortion…….. Well YOUTHCANN never promotes abortion. We are pro-choice and we respect informed choice and decision of every woman. We encourage young people to use modern contraceptive to prevent unwanted pregnancy which may lead to abortion. Even if Government has been giving more emphasis to contraceptive and it is free in almost all the health facilities, women do seek for abortion services. We encourage women and men to have safe and legal abortion which has less complication instead of unsafe traditional abortion which leads to death.

The participants were more curious to know about data on abortion and its failure rate. Also, they were keen to know the percentage of young women going for abortion. They perceive various myths on abortion like:

  • Infographic-2Most of the young unmarried women undergo abortion.
  • Abortion is a crime.
  • Fetus has its right of survival
  • Young people are using abortion as family planning.
  • Repeated abortion is dangerous.
  • Service providers do not want to perform abortion
  • INGOs are promoting abortion.
  • Abortion leads to infertility.
  • Woman needs husband consent for abortion.
  • Young people should not be given SRHR information and access to service.

All these Myths are cleared by the resource person Madhabi and Deepndra Khaniya. Deependra Khaniya is Managing Director of nation’s leading radio station Radio Audio which supports young people’s SRHR and on-air program on safe abortion. Deependra shared that his team receives more than 200 SMS daily from young people between 15 and 24 years which is mostly related to SRHR. Even if we do not allow young people to talk, listen and see SRHR stuffs they will definitely receive information from somewhere which might be incorrect and lead to unexpected situation. These days young people are more prone to social media and it is not always necessary they absorb only good information. Even we are helpless to block or stop the inaccurate information to reach our young people. Therefore, it is our job: media people’s job to clear our own values regarding abortion and provide reliable information to them.

Media should be sensitive when they write articles, news and on-air program on safe abortion. No woman undergoes abortion with her interest. It’s due to some reason and media should analysis those situation. One of youth champion shared that she had read an article which says, “Young girls in school uniform goes to abortion clinics and its increasing.” Well most of our government health facilities are Youth Friendly Service centres. It remains after school to reach most of the young people with information on SRHR. It’s government’s initiation. The YFS centres are in health institutes which provides safe abortion service as well. So, it would be discrimination to young school going girls if we publish on one sided information. May be she was there in health facilities for science project work or her regular meeting with community girls. This kind of bias information only hampers young girls and our country will never progress.

Youth Champion Prabina Sujakhu led value clarification exercise. Upon asking the statement: HIV infected woman should not give birth, most of the participants raise their hand in favor to the statement. The concern was if mother is infected she is not health enough to give birth to healthy baby. Some said infected mother gives birth to infected baby. Upon asking what if she knew pregnant. Most of the participants replied abortion is best option for her. But we facilitator shared its her right whether or not she wants to have her baby and knowing about safe procedure now we have in medicine which protect baby form HIV infection, the participants were forced to rethink.

Likewise, on asking whether husband’s consent is necessary for abortion most of the male participants were in favor to the statement stating mutual decision is the best which won’t lead to disturbance in family. Due to conflict in family, the marriage ends in divorce. But female participants shared that its woman’s body and she has her full right to decide about her pregnancy. There were argument between male and female participants on this statement.

Similarly, on asking abortion is killing fetus all most all the participants agreed upon address fetus as baby and life starts from conception. But the participants seem to be convinced when facilitator shared that there is not any study to show when life begins. Fetus depends on woman’s body as parasite. Life is only counted when it survives with its own.

At the end of the program, a video was shown “News Room Bahira”. The video talks about Sushila Jaisi’s death due to unsafe abortion. This video make the participant realized that even if there is availability of contraception for free of cost, abortion occurs. Abortion is always woman’s last decision. Use of contraception leads to prevent abortion.

The participants shared that this was the first time they had attended session on abortion. They realized bias information leads to #abortionstigma and discrimination. They also promised to contact YOUTHCANN for accurate information and resource materials on abortion as well as SRHR. In deed it was a fruitful orientation.

Youth Advocacy Institute & Fertility Dance

Tell me which part of your body you love the most? The answers would be: Eyes-it helps me to see beautiful scenario in Colombo; My nose- it helps me to breathe warm breeze of Indian sea in Sri Lanka; My legs: it helps me to travel wherever I want; My hair: my pictures look amazing with my black & long hair. And what about your genitals??? emmm…. GENITALS? WHAT ESPECIAL ABOUT THAT?? well….. never thought about this….

It has been always great to be part of Youth Advocacy Institute every year organized by Asia Safe Abortion Partnership. This time it is in Sri Lanka. The time for reunion with senior Youth Champions and ASAP team. The joyful venture to meet rising SRHR advocates from various countries. YAI always motivate me to keep on working in SRHR field and advocating for women’s right to safe and legal abortion. This year I am here as peer facilitator and got wonderful opportunity to co-facilitate session on Reproduction and Contraception with Dr. Suchitra.

Coming back to genital organs and the embarrassment to pronounce the part of our genitals in front of other people. We are youth champions. We have taken responsibility to aware 1000s of young people back home regarding their SRH needs, rights and access to services and information. How could we be embarrassed to say “PENIS”, “SPERMS”, “VAGINA” ??? We should shout it loud and inspire people to demystify the myths related to these terminologies.

I believe unless you know the subject in reality it would be difficult to teach other people. After introductory session on reproduction & contraception, we moved to a session which termed as “FERTILITY DANCE”. A huge uterus was drawn on the floor. This session is generally a role play. Lets do this…. what… lets have sex….. well I am kidding…. but lets learn reproduction and mechanism on women’s body. Various cheats were distributed to youth champions which says IUCD, IMPLANT, OCP, CONDOM, PENIS, OVA, SPERMS, etc. Now they had to enact the characters.

Talking about sperms, they are active, fast and clever as they have to fertilize ova for reproduction. IUCD, its probably T-shaped and has to be fitted in the uterus in T shape and fight with sperms. Hormonal contraceptives like OCP, IMPLANT and Shot they could hold ova so tight that it won’t be able to release in Fallopian tube. The enthusiastic YCs acted so well that the session turned to be fun and infotainment.

This session is in deed interesting and full of energy. This helps you to understand how fertilization takes place in uterus and how a woman conceive. Even convincing when you facilitate session to women’s groups, youth groups, mother’s groups to make them understand the mechanism and clear their myths related to contraceptives, safe abortion pills and other.

To know more about Youth Advocacy Institute click here.

Menstrual Hygiene Champions 

Last week after our biggest festival, Tihar I met bunch of enthusiastic young girls. We were there in Female Friendly Space to discuss about disaster and its effect on young girl’s menstrual health and hygiene.

One of the young girls shared that when the devastating earthquake hit Nepal in 25th April, she was due with her menstruation. The ground was shaking so her uterus too. However she had bleeding for a day. She was worried and there was no one to talk about as continuous aftershocks were killing people mentally. Likewise, another girl shared her menstruation was delayed almost two months after earthquake. She was worried about it but was happy enough as she did not need to stress about her period when everyone was facing trouble due to earthquake.

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It has been almost eight months after the earthquake. People in Nepal are still living in temporary shelters. It was really difficult when we started our relief activities for earthquake victim in affected areas. Our intervention was to access on SRHR need of affected people. They did not want to learn about menstrual hygiene and its importance.  In some places, people even rejected to take sanitary napkins that we distributed. Therefore, we thought to work with schools and teachers in affected districts on menstrual health management. It requires more young facilitators to approach schools and train young girls on menstrual hygiene and home made sanitary pads. We trained about 15 young girls on menstrual hygiene and mobilize them.

Meeting these wonderful young girls and orienting them on menstrual health I came across with different stories. We talked about their first menstrual experience. One of the participant shared she was alone at her home when she had her first bleeding. When she woke up, her bed sheet was stained with blood. She did not know from where she bleed. Shock checked every where but she could not figure out. Later her mother gave her cloth to place in underwear. But her mother did not explain her what actually happened. She had to learn herself.

IMG_2412All laughed when she shared her story saying I thought I had serious disease that led to heavy bleeding continuously from her private part. She shared she cried thinking she is going to die soon before she gets married. Well marriage in our culture has high regards and its that important that every girl dreams of it.

Now, we have huge team to aware and educate other young girls about their menstruation before they bleed without knowing anything. We named the team as menstrual hygiene champions. The journey begins and our champions have already started to approach schools and train school students on menstrual hygiene and preparing home made sanitary pads.

One of our champions who being to schools and met teenagers shared theIMG_2518 girls think talking about menstruation is an embarrassment. Another champion shared that even teachers thinks menstrual fluid is impure. This means we have started to intervene in traditional understanding of menstruation. We believe change take times and our menstrual health champions are change makers.

 

 

10 Things You Should Know about Abortion Service in Nepal

This has been my tagline from my first blog post till today “Abortion is Safe and Legal in Nepal”. Nepal has passed its glorious 10 years and more after liberalizing abortion laws and respecting women’s rights to control their own body. It’s icing on the cake when recent national budget 2015/16 announced abortion service in government institutions being free of cost. Also, the NEW CONSTITUTION DRAFT of Nepal has “Guaranteed women’s right to reproductive health and has removed of the term BHRUN HATYA.”

The previous article 43(2) had stated…every women shall have right to safe-motherhood and reproductive right. Bhrun Hatya done on the basis of sexual identification will be punished. Now the new and current provision in the constitution draft in the very same article number i.e. 43(2) states EVERY WOMEN SHALL HAVE THE RIGHT TO SAFE MOTHERHOOD AND THE RIGHT TO REPRODUCTIVE HEALTH.

map-about-bigtext1Yes, it’s my body and I’d rather not have anyone telling me what to do with it. Motherhood is an especial feeling but women could not only be judge on the essence of pregnancy and delivering babies. Unwanted pregnancies can cause many issues and effect health of women as well. But even if the pregnancy is not caused by a rape or causing health issues on woman, my body is mine and i have full right to decide what I want. I know that this is very hard concept for many people to grasp but it’s just the way I feel.

Having said that I am a pro-choice and I support women’s right to safe abortion, I would like to share 10 things you should know about abortion service in Nepal.

  1. Legalization of Abortion:

You should be aware of legal conditions for safe and legal abortion in Nepal. There are legal conditions under which you can go ahead with abortion service in Nepal.

Abortion http://www.asap-asia.org/country-profile-nepal.html is legal in Nepal on the following grounds:

  • Up to 12 weeks of gestation for any women,
  • Up to 18 weeks of gestation if pregnancy results from rape or incest, and
  • At any time during pregnancy, with the advice of a medical practitioner or if the physical or mental health or life of the pregnant woman is at risk or if the fetus is deformed and incompatible with life

Abortion is punishable on the following conditions:

  • Sex selective abortion, and
  • Abortion without the consent of the pregnant woman

Sex selective abortion is big “NO”. This is  important for everyone and especially for young people to be aware of legality of abortion in Nepal. Young people are innocent and often they seek abortion service beyond legal limit. OR they are subject to family and society pressure to keep their pregnancy secret, pushing those who ultimately decide to seek abortion beyond legal limit. Because of this many young people have been denied of abortion. Therefore, awareness on safe and legal abortion among young people is must so that they go to abortion service centres within legal time frame. The denial of abortion service beyond legal limit has lead to unsafe abortion.

2. Abortion procedures:

In Nepal, as is true for most other countries of the developing world, women are rarely given the opportunity to voice their needs concerning health matters. But legalization of abortion in Nepal undoubtedly has empowered women and health status of women. Comprehensive Abortion Care Services is an additional powerful tool in addressing high maternal mortality.

There are two types of medical procedure that is used in Nepal: MVA-manual vacuum aspiration and MA- medical abortion. Medical abortion is performed within 9 weeks of gestation. Medical abortion is a method of using pills to end a pregnancy through a process similar to a miscarriage. Like vacuum aspiration, medical abortion is very safe and effective. It offers unique advantages. It provides a non-invasive method of ending an unwanted pregnancy that women can use in a range of settings, often in their homes.

Safe and legal abortion services providers should counsel its clients regarding the methods of medical procedure being available in the service centre. It is the choice of woman on going through medical procedure via MVA or MA.

3. Identify safe abortion service centres:

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Safe Abortion Logo

Comprehensive Abortion Care Services are made available through the private, non private, semi-governmental sectors to provide abortion services in under served areas and to marginalized populations. Government of Nepal has developed a safe abortion logo. It is a visual symbol to designate facilities offering safe abortion services that is prominently displayed at all abortion service sites. Through its extensive incorporation in safe abortion IEC materials and programs. the logo has been a widely recognized symbol of safe abortion in Nepal, particularly among vulnerable populations such as illiterate women. Perhaps have also used behavior change communication strategies- including evidence based community discussion groups and a serial radio drama to foster discussion about sexual health and to challenge commonly held negative beliefs and stigma around induced abortion.

Likewise, the Government of Nepal certifies the health facilities as well as health service providers with trained human resources (doctors, nurses, ANMs) to provide abortion services to women. Abortion service and care is now available in all 75 districts of Nepal, many of which are in remote, mountainous areas, reflecting the government’s emphasis on rapid decentralization.

4. Privacy and Confidentiality and Counseling:

Quality service is the integral part of abortion service centres and it is right of women to receive standard sexual and reproductive health service. Abortion is very sensitive issue to be talked and decide to go for the procedure. Before safe and legal abortion, counseling regarding abortion and its procedure is the most. Woman has right to choose the correct abortion procedures: MVA or MA. For this proper balanced counseling is the most. Similarly privacy and confidentiality is the most. There are evidence which states that young people and women do not prefer to visit their nearby health facilities for any sexual and reproductive health services as they might meet their relatives and friends or service providers might know their family. They prefer travelling far to next districts for even simple SRH service due to lack of privacy and confidentiality in their nearby health facility.

So it is necessary that health facilities and even service providers maintain privacy and confidentiality. If they do not, everyone has right to ask for and if not maintained legal action could be preferred.

5. Hotline service:

Meri Saathi Free Helpline In Nepal, there are limited hotline service centres which offer information on safe abortion: legality, procedures, dos and dons, queries, safe abortion services. But Marie Stopes Nepal offers range of sexual and reproductive health counseling over phone. They have trained and skilled counselors who are available six days a week and provide information on safe abortion. It is call Meri Saathi Free Helpline. You can dial 16600119756 or 9801119756 to get accurate information on abortion service centers. These numbers should be saved in your cell phone. In any emergency regarding sexual and reproductive health issues, the solution could be a dial away.

6. Abortion service centres- Youth Friendly 

All abortion service centres should be youth friendly. Safe and legal abortion is young people’s sexual and reproductive health rights. The service providers should be youth friendly. They should not have their personal values which hold them back when it comes to providing abortion service to young girls. Even the service centres need to be youth friendly with IEC materials being demonstrated, well received in the centre, non-judgmental, privacy and confidentiality.

7. Abortion and Consent:

This is an important topics to be discussed widely. When it comes to abortion and consent, most of the people think that consent from husband, boyfriend, family, etc is compulsory. But in our abortion law it is clear that “Only pregnant woman holds the right to choose to continue or discontinue the pregnancy.” This states that only pregnant woman’s consent is enough to get abortion service. If the pregnant woman is less than 16 years of age or not in a position to give consent (mentally incompetent), the nearest guardian or relative can give consent for abortion services.

8. Accessibility and Affordability:

Abortion should be accessible and affordable. As mentioned above abortion services in Nepal are available in all government institutes like Primary Health Care, Health post and Sub health post in all 75 districts. Service providers are trained to provide both MVA and MA services to women in urban as well as rural areas. Even various organizations like Ipas Nepal has been training Female Health Volunteers to aware community about safe and legal abortion services being available in their nearby health facilities. This is indeed good initiation to prevent unsafe abortion. The fee structure established for public-sector maternal health services set a standard fee of about Rs. 1000 for induced abortion. Although modest, this fee was in contrast to free provision of post-abortion care, delivery, pre-and post- natal cares, and long-acting contraceptives. The safe abortion policy does stipulate that services be provided free of charge to poor or otherwise marginalized women. With continuously advocacy by women’s health advocates, women’s right activists and health organizations “Abortion has been free of cost in government institutions”.

9. Post Abortion Family Planning counseling:

Safe abortion needs good quality abortion services incorporating counseling training human source, infection prevention practices and adequate logistic support. Abortion is also supported by contraceptive services to prevent further unwanted pregnancy. Post abortion family planning benefits individuals, families, communities in many ways: increased modern contraception use and decreased abortion, reduced maternal and child mortality, prevention of mother- to -child HIV transmission and new HIV infections. After abortion procedure, post abortion family planning counseling is the most.

10. You are a champion:

Now you are aware of all the abortion related information, you are indeed great messenger and champion who is responsible to relay accurate message on abortion being safe and legal in Nepal to other people in your circle. You are a Champion.