News from regional networks
ASAP Satellite Session at the 5th Asia Pacific Conference on Sexual and Reproductive Health and Rights (UPDATED 09.11.2009)
There are following available presentations from the ASAP´s session:
“Safe Abortion in Asia. Making it work !”,
Dr S P Choong, MB,ChB. FCA Chair, Asia Safe Abortion Partnership (ASAP)
“Introducing medical abortion into the public sector in Nepal”
Dr B K Suvedi, Director, Family Health Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
“Making Abortion Safe in Asia: Singularity of Focus”,
Priya Nanda, International Center for Research on Women (ICRW)
“Medical Abortion Training in Asia: Innovative Approaches. Case studies from Ipas’s experience”,
Phan Bich Thuy, MD, MPH
ASAP Satellite Session at the 5th Asia Pacific Conference on Sexual and Reproductive Health and Rights (UPDATED 30.10.2009)
SAFE ABORTION IN ASIA – MAKING IT WORK
Asia Safe Abortion Partnership held a Satellite Session (SS) along with four Partners at the 5th APCRSHR held in Beijing on 19th October 2009. The Partners were Concept Foundation, Ipas, International Centre for Research on Women (ICRW) and IPPF ESEAOR.
There were about 30 committed people present in the audience.
Objectives of the Satellite Session were：
- To revisit abortion issues in Asia
- To review new challenges and strategies to improve access to safe abortion
Dr Suchitra Dalvie, Coordinator, Asia Safe Abortion Partnership was the facilitator of the session. She thanked all the partners for sharing this session with ASAP and then introduced all the speakers. She spoke about how it is becoming increasingly important to speak more often and more openly on the issue of safe abortion to overcome the culture of silence and stigma that surrounds it.She then invited Dr Priya Nanda (Group director, Social and Economic development, Asia Regional Office, ICRW), to present her talk on Exploring the Transformative Potential of Medical Abortion for Women in India.
Dr Nanda spoke about the situation of safe abortion access in Asia and how we need a singularity of focus to keep safe abortion on the agenda of Sexual and Reproductive Health and Rights. She presented a study the results of a study which identified the positive and potentially transformative attributes of Medical Abortion. Women found the transformative potential in its confidentiality , while program and policy persons acknowledged the possibility of training non MBBS doctors and nurses as well as being able to expand this method in the public sector as a paradigm shift in the way safe abortion services have been constructed so far. She also noted that the introduction of the comb-ipack is likely to further facilitate the de-medicalization of this service.
The next speaker Dr. Helena von Hertzen ( Senior Advisor, Concept Foundation, Switzerland) spoke on The New information on regimens for Medical Abortion.
She discussed the results of recent studies on the newer regimens of mifepristone and misoprostol and the various routes it can be adnministered by. The regimen of mifepristone followed by a suitable prostaglandin analogue has been licensed in over 40 countries, and in many of them most early abortions are now induced with this method. The experience suggests that medical abortion is acceptable to women and safe when provided under proper conditions.
After her, Dr.Phan Bich Thuy (Training & Services Senior Advisor , Concept Foundation, formerly with Ipas Vietnam ) presented on Medical Abortion Training in Asia: Creative Paths.
This presentation highlighted various medical abortion training approaches and lessons learned from Ipas’ efforts over the last years at providing such training in different parts of Asia. These include training of providers, whole site training for performance improvement, use of blended learning techniques and also innovative ways to reach the community using women’s clubs, street dramas, low literacy materials and radio.
This was followed by presentation from Dr BK Suvedi (Family Health Division Ministry of Health and Population, Nepal) on Introducing medical abortion into the public sector in Nepal.
He presented findings from a pilot programme on the introduction of medical abortion, which initiated this service in January 2009 in six districts in Nepal. The presentation discussed the development and implementation of a strategy for the systematic introduction of Medical Abortion. It highlighted how it has involved coordination and collaboration between the public health system and all key stakeholders to build a supportive health system for the provision of medical abortion within the context of comprehensive abortion care.
Dr SP Choong (Chair, ASAP, Director of a pioneer ambulant abortion service provider inMalaysia since 1975.Past chairman of the Federation of FPAs Malaysia (1992-1996).
Co-chair of Reproductive Rights Advocacy Alliance Malaysia) concluded the session with ASAP: An Asian Network for Advocates of Safe Abortion.
His presentation reflected the outcome of the organization and activities of the Asia Safe Abortion Partnership ( ASAP ) and the need for creating a forum to discuss issues related to safe abortion. He noted that it had been over 15 years since ICPD, 20 years since Mifepristone use started and we still seem unable to simply make access to safe abortion! He higlighted the importance of identifying obstacles and opposition and working out suitable strategies as there are Pro-life groups in the societies which are well organized and funded. He advocated that perhaps the time has come to criminalize anti-abortion laws and the need to demedicalise service provision.
He pointed out that safe abortion advocates in Asia are still operating in relative isolation in their countries and there fore regional networking is important to give them support. There is still a need to eradicate the taboo associated with any discussion on abortion. Also we need to understand that the full potential offered by ‘newer’ medical technology like medical abortion and manual vacuum aspiration is far from being realized. Therefore it is important to give information and educate all women on various methods of abortion to enable them to make their own decisions on their reproductive health and this will translate into greater confidence in
He concluded by saying: Together, we can make it WORK!
Dr. Dalvie then opened the floor for questions from the audience.
Q 1: Toan :Which regimen would you recommend to use and is it cost effective to give 400 µgms vs 800 µgms ?
Dr. Helena von Hertzen : If we are 100% sure of the gestation age being < 7 weeks , Mifepristone 100mg along with Misoprostol can be used. But we may need more Misoprostol. It can be administered sub lingually upto 8 weeks. Two tablets of misoprostol followed by another two later on. We can shorten the interval at early gestational age but not in later gestation. More prostaglandins are required with one day interval at later gestational age.
Q 2: Rostom from Phillipines, where abortion is still illegal.
How do we work with abortion issues underground along with the feminists? What is the capacity of the group to bring feminist ideology into this ?
Dr Nanda: It depends on how mature is the movement and in what context you are talking about it. In the countries where abortion is illegal , a lot of advocay campaigns are taken up by feminist movements compared to the countries where it is legal .
In India, there are other pertinent issues on the agenda of feminists, other battles to be fought, and so abortion just receives a smaller share of the attention. We talk of abortion because it is brought under the umbrella of family planning.
The other issue is sex- selective abortion, creating much more stigma against abortions . There we don’t know which is the right panel to talk about abortion and about sex selective abortion. But we should remember that the concern is around sex selection and not around abortion. There is a need to energise the feminists on broader issues.
Dr. Choong added that this is very true and that we are talking much more on the issues of violence against women, divorces, etc. Also, in Asia we experience religious opposition too. We have now started to join in and we are talking on rights and also on abortion.
Dr. Thuy: Women working only on abortion issues are few. But we add abortion as a topic in many other topics of work. We put safe abortion with safe motherhood component, or the family planning, prenatal care component. There are monthly activities and one topic in that is about abortion.
Q3. Dr. Choong to Dr. Suvedi.
How did you make it happen in Nepal overnight? How did you make abortion issues acceptable in Nepal? At one point of time you arrest a women and put her in jail because she had an abortion, and the next day you free her because abortion is now legal?
Dr. Suvedi: This is not an overnight change. In Nepal, the struggle on abortion has been very long, since 1979. It has been in legislature/ parliament for a very long time. Even now there are reservations. When we talk about advocacy with these people we must remember that any complications while giving safe abortion services to any women one can revert our case.
Dr. Dalvie closed the session by thanking the speakers for their excellent presentations and remarked that the struggle has been really long one, and with so much opposition, but we can together make it work!
ASAP Satellite Session at the 5th Asia Pacific Conference on Sexual and Reproductive Health and Rights
We are very pleased to announce that The Asia Safe Abortion Partnership (ASAP) will conduct a Satellite Session at the 5th Asia
Pacific Conference on Sexual and Reproductive Health and Rights, Beijing China, 18-20 October 2009.
ASAP partners in this session are:
- Concept Foundation
- IPPF ESEAOR
- International Centre for Women (ICRW)