Is our Voices Still Voiceless?

_BSL9604I observed the so called Reproductive Health Right activists/ advocates are still afraid to talk about abortion issues in public. “We should not sound like we are promoting safe abortion. Our action needs to be subtle. This will have good impact on media. Our message won’t be misinterpreted”- one of the Reproductive Health Right Activists.  SERIOUSLY!! You are the one who has good following in your network and outside. You can influence 1000 of people in and around. But you are feared being  misquoted.

I had same observation when we were celebrating third national safe abortion day. To mark Safe Abortion Day- 28th Sept 2017, Reproductive Health Right working group organized a candle light event to remember women who lost lives due to unsafe abortion by lighting candles. There are series of program the working group will be organizing which aim to campaign as a movement to promote universal access to safe, legal and confidential abortion as a women’s health and human rights issue.

We celebrated the candle light event in the most heaped area of Kathmandu where biggest political protests, social campaigns and discussions take place every year. All those discussions are fairly covered in the media and have great impact on readers. Ultimately, this is what we wanted when it comes to media coverage on abortion to spread relevant facts on safe abortion to demystify stigma surrounding the issue. Only 38% of women are aware of legality of abortion in Nepal. It has been 15 years of abortion legalization in Nepal and women are still seeking unsafe abortion resulting into complications. This article gives us a glimpse to real women accessing abortion in Nepal.

I participated in the event too. We had play cards with information on abortion. I requested the team to let’s go outside of the place and display the play cards to general people so that they will be informed on what we have been doing in the Mandala. The team hesitated to do so. It seems like they wanted to completely the event in few seconds sharing information within us and leave the place before someone comes and interrogates on lightening candles. It’s a public place and we are supposed to invite more than 100 people and start interacting with public on abortion being safe and legal in Nepal. Only thing that going around my mind was “Could you please leave to young people? We have much more and effective ideas to make this event memorable. Kindly get us in the board and discuss with.” Upcoming generation should be aware of why abortion needs to be safe, legal and confidential.

All Reproductive Health Right activists are scare of getting into trouble. Or should I called it getting their name in front page of national newspaper associating them with abortion. This is called DOUBLE STANDARD. We are supposed to spread accurate and reliable information on Safe and Legal abortion outside of our network. We, as abortion activists have enough information on abortion being human right. This needs to be replicated to those who are unaware and against safe & legal abortion. The objective of celebrating international campaign on safe and legal abortion is to aware communities, sensitizing media, advocating political parties and reforming unfavorable laws and policies which are barrier for a woman to access her right to healthcare. However, this event was celebrated only in the presence of organizations, partners and stakeholders who are pioneer on advocating for abortion. This in deed won’t support our campaign to make our voice heard. IS OUR VOICES STILL VOICELESS? Obviously yes!

We as abortion activists are not prepared to answer the question “Why are you promoting ABORTION?”. We always try to avoid the questions and most reply “We are not promoting abortion. We are promotion family planning”. As if “family planning” is the solution to prevent abortion incidence. If it was all Government health facilities and NGOs have been promotion free family planning services for many decades now. Why we are not confident answering this simple question. Unless our collective voices won’t advocate for  “Abortion”, the issue will be stigmatized every time.

Last year, we organized similar program in same place lighting candle in memory of women who lost their life due to unsafe abortion. One of the social media group posted saying “What a shame! People are celebrating the issues which kills unborn child”. On sharing the issues with the team working for women’s choice and access to safe abortion, they do not strategy to deal with hate comments/ negative remarks. One of them told, “Don’t worry! This will not make sense.” WHAT? The page has more than 1000K followers, mostly young people. The young people have started supporting the notion ” Abortion is not safe. It should be punishable.” It’s surprising when the activists close their eyes saying these remarks won’t affect the cause. Anti abortion groups are actively working in Nepal and they are not leaving an opportunity to stigmatize abortion. But we are carefree and are not setting strategies to back out those hater calls. Then we, Youth Champions took the initiation and at least try our best to reply positively sharing facts and data. It is important to clear the myths and misconception associated with abortion. If we don’t, this will stigmatize activists like us for advocating for safe abortion.

We need to make more noise to make our voice heard by women and young girls in communities. Around 322,000 women undergo abortion in Nepal every year and more than 186,000 cases are unsafe. Unless our campaign are effective and our messages getting to women and young girls, we won’t be able to reduce unsafe abortion cases. More than 3,000 health professionals have been mobilized in safe abortion service in Nepal. Around 1,100 health facilities have been authorized to carry out the comprehensive abortion care. We need to shout-out in all possible ways to aware people about safe and legal abortion sites and these sites providing safe, legal, confidential and free abortion service which is carried out by trained and qualified health professionals.

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Youth SRHR policies in Nepal

The article is originally posted in http://www.yuwa.org.np/wp-content/uploads/2012/06/YUWA_SRHR_Policy_brief.pdf. 

Youth have become focal points of discussions and debates regarding sexuality and reproductive health matters. However, little research has been done particularly in Nepal to examine their knowledge concerning sexual and reproductive health & rights, abortion as well as contraception. Research indicates that a substantial proportion of adolescent pregnancies are unintended or unwanted. Sexual and Reproductive health issues are very sensitive. Thus having accurate and comprehensive knowledge about SRHR is pivotal, in the case of unintended or unwanted pregnancy or when engaging in unprotected sex or experiencing contraceptive failure that could lead to pregnancy.

While, there are policies addressing sexual and reproductive health broadly in Nepal, they are not being implemented effectively. Furthermore, few policies specially target youth and those addressing sexual and reproductive health issues have been formulated without young people’s involvement.

Agreements, Policies, Strategies, Plans and Programs supportive of Youth sexual and reproductive health

Nepal Has signed various international declarations that commit to young people’s sexual and reproductive heath, including the International Conference on Population and Development (1994), Fourth World Conference on Women in Beijing (1995) and the Millennium Development Goals (2000).

Nepal’s safe Motherhood Program (1997) has the objective of reducing mortality and morbidity among women and newborns during pregnancy, childbirth and the postnatal period, through the adoption of a combination of health and non health measures. For the effective implementation of the program, the National Safe Motherhood Plan (2002-2007) was developed and includes language that supports the sustained increase in utilization of quality material health services.

The Safe Motherhood and Neonatal Health Long Tern Plan (2006-2007)gives priority to the reduction of maternal mortality and neonatal mortality by increasing the number if skilled birth attendants, increasing health services and public private partnerships, improving access to information and services relating to safe motherhood, and strengthening community-based awareness on birth preparedness through the Female Community Health workers’ Program.

The National Reproductive Health Strategy (1998) brings forth integrated reproductive health packages at all levels by calling for advocating for reproductive health; reviewing and updating Information, Education and Communication (IEC) materials & training; strengthening management systems (especially for reproductive health) at all levels; conducting reproductive health research; constructing and upgrading appropriate service delivery and training facilities; developing reproductive health programs for adolescents; supporting national experts and consultants; and promoting inter-sectoral and multi-sectoral co-ordination.

The 11th Amendment Bill on Abortion (2002) allows abortion in the following circumstances: up to 12 weeks gestation for any woman; up to 18 weeks gestation if the pregnancy results from rape or incest; and, any time during pregnancy, with the recommendation of an authorized medical practitioner, if the life of the mother is at risk, if her physical or mental health is at risk, or if the fetus is deformed. However, abortion will be punishable by law if it is practiced for sex selection or if it is performed without the pregnant woman’s consent.

The National Health Policy (1991) addresses maternal health and family planning as preventive health services. The National Health Policy seeks to ensure provision of maternal health and family planning services through all the service delivery points of the government health system.

The National Adolescent Health and Development Strategy (2000) directly targets adolescent health and has the objective of increasing the availability of and access to information on adolescent health and development. The strategy also calls for providing opportunities to build skills among adolescents, service providers, and educators; to increase accessibility and utilization of health and counseling services by adolescents; and to create safe and supportive environments for adolescents to improve their legal, social and economic status.

The National Youth Policy (2010) states that youth shall be encouraged to have safe and positive sexual activities, while providing them with education on sexual health safety and freeing them from all kinds of sexual violence. A strategy shall be adopted to keep the Nepalese youths in general from HIV/AIDS, making them aware about possible risks of HIV/AIDS through public awareness programs. In addition, environment shall be created for the youths who are infected from HIV/AIDS to live a dignified and easy life in the society, by running special counseling service centers, regularly providing anti-retroviral medicines to such youths in an easily accessible manner, and providing the infected youths with skills-oriented education, while freeing such youths from all kinds of social discrimination being made against them.

The Second Long Term Health Plan (1997-2017) guides health sector development by outlining approaches to address the disparities in health care, taking into account gender sensitivity and equitable community access to quality health care services. The Plan specifically addresses ways to increase use of modern contraception, antenatal care, and deliveries conducted by trained personnel.

The National Free Health Care Program (2006) provides free maternity services, maternity incentives, free family planning services, and antenatal checkups at all the government health service delivery points.

Although Nepal has plenty of policies, strategies, plans and programs supporting youth sexual and reproductive health, young people lack access to sexual and reproductive health information and related services. They are poorly equipped to face challenges and are in need of skills, education and information to enable them to make informed choices about their sexual and reproductive health and rights. Despite existence of national guidelines that call for youth-friendly services, sexual and reproductive health services that are youth -friendly are lacking. Young people’s meaningful participation in policy making that provides leadership opportunity and ownership is limited despite an increasingly conducive environment for youth engagement. Participation of marginalized young people is particularly lacking in spaces to inform policies.