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Sub-Saharan Africa

ONIDS is an organization composed of activists, mostly women, girls and teenagers. The organization is committed to the promotion and protection of the social and health rights of the most vulnerable and marginalized people and aims, through awareness raising, training and advocacy, to improve the well-being of marginalized people using a collaborative and human rights-based approach.

The liberalisation of some aspects of the abortion law in Burkina Faso in 2018 remains unknown by the general population but also by many working in the fields of health, education, and the law. ONIDS' SAAF funded work focuses on sharing information about the conditions of access to abortion and to direct women seeking care towards safe providers.

Visit the Organisation pour de Nouvelles Initiatives en Développement et Santé (ONIDS) website.
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Cameroon

Anonymous organis­ation

In Cameroon, complications resulting from unsafe abortions are the third leading cause of maternal morbidity/mortality. Lack of access to adequate and appropriate SRH services, restrictive sexual health and rights compounded in rural areas by; discriminatory/oppressive cultural taboos, poverty and ignorance contribute in the high prevalence rate of unwanted pregnancies (roughly 40% of all pregnancies in the country are unintended, and 36% of these end in abortion). Most rural women/girls tend to resort to clandestine/unsafe abortion methods that often end with complication and access to post-abortion care is limited. This project seeks to increase access to post-abortion care and contraceptive services for rural women and girls in Ngoketunjia Division. The project will also contribute in changing community attitudes towards stigmatisation of women seeking SRHR knowledge and services.
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Congo, DRC

Comité d’Echange et d’­Information sur la Femme et pour le Développe­ment (CEIFD)

CEIFD works in South Kivu, in the East of the Democratic Republic of Congo. South Kivu is a conflict zone with high incidence of sexual violence, consequent high levels of unwanted pregnancy and unsafe abortion and limited availability of reproductive health services.

CEIFD have been supported by SAAF since 2014 to tackle these issues by providing training and supervision to 20 health facilities, to ensure the availability of safe post-abortion care and contraceptive services.They also conducts awareness raising sessions with local decision makers and the wider community, with a view of reducing abortion-related stigma.
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Congo, DRC

Groupement des Femmes Vivant avec le VIH

Based in the conflict area of South Kivu in Eastern DRC, GFV faces a high level of need for sexual and reproductive health services. Through their SAAF-funded work, they aim to ensure that women and girls have access to safe post-abortion care and harm reduction services. They specifically aim to improve knowledge of access to abortion-related care and harm reduction for women in the Lulimba-Misisi-Nyangi mining area in Fizi territory.

They use multiple strategies, such as strengthening the capacity of structures to provide quality services and engaging the local community to inform, educate and raise awareness on sexual reproductive health issues, with a particular aim of addressing the stigma surrounding abortion.
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Abortion was illegal under nearly all circumstances in the Democratic Republic of Congo (DRC) despite the country being a signatory of the Maputo protocol. However, as of 2018, abortion was legalised under many more circumstances with the Maputo Protocol being published in the national legal gazette. Due to years of illegal abortion and lack of knowledge about the new law however, unsafe abortion remains a large cause of illness and death.

Si Jeunesse Savait (SJS) focuses on supporting young people in the capital Kinshasa. They have been providing harm reduction information to young people and campaigning to change the law for a number of years. Under this SAAF supported project they work largely with young people, highlighting the dangers of unsafe abortions and the need to access safe care, improve referral to youth friendly abortion care facilities and share best practice within the sector on how to improve programming to support adolescent girls.

Visit the Si Jeunesse Savait website.
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Unsafe abortion contributes significantly to a high maternal mortality in Ghana, particularly in the three northern regions. Although the abortion law of Ghana is relatively liberal, safe abortion services are non-existent in some districts, knowledge of the abortion law is low and stigma is high.

Through this SAAF-funded work, MABIA-Ghana works in two under-served districts of Northern Ghana in the Upper East and Northern regions. They aim to increase knowledge of legal rights to abortion among school students and to introduce quality, non-judgemental, comprehensive abortion care to women and girls in public health facilities, at the same time ensuring that two midwifery training colleges are able to provide quality pre-service training on safe abortion to trainee midwives.

Visit the MABIA-Ghana website.
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KELIN was originally established to protect and promote HIV-related human rights; however, their scope has since expanded to include all sexual and reproductive health and rights in relation to key affected populations through targeted litigation and advocacy.

With SAAF funding KELIN use their litigation and advocacy skills to improve the legal environment through the enactment of a model Reproductive Health law in Nakuru County. They also plan to develop a legal precedent on the unconstitutionality of retrogressive county laws through strategic litigation and expand their litigation fund to provide legal support to health providers and clients targeted for abortion related offenses.

Visit the Kenya Legal & Ethical Issues on HIV and AIDS (KELIN) website.
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TICAH’s aim is to promote health. Their focus is on good relationships, healthy households, and community action. Their SAAF funded work aims to make reproductive choice and safe abortion understood and accessible to a wider range of Kenyan women and girls especially young, underserved and vulnerable women.

Working with women and girls in Nairobi, Eastern and Coastal province, TICAH aims to improve their knowledge, agency and ability to make choices on contraception and safe abortion. SAAF funding is also used to strengthen the Aunty Jane hotline that people call from across Kenya to get information on sexual and reproductive health issues.

Visit the Trust for Indigenous Culture and Health (TICAH) website.
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The Centre for Solutions Journalism (CSJ News) based in Blantyre, Malawi is an NGO founded by media specialists that focuses on professional dissemination of news and best practices that offer solutions to social, economic and development challenges facings Malawians.

With SAAF support, CSJ News is focused on advocating for the enactment of the Termination of Pregnancy Bill in Malawi which would legalise abortion under a number of circumstances. The project builds the capacity of women's groups to advocate for abortion law reform as well as lobbying MPs directly to get their support. The key activities of the project will be lobbying (engagement with lawmakers), capacity building (training of rural women advocates) and production and broadcasting of an abortion law reform radio programme and jingles.

Visit the Centre for Solutions Journalism (CSJ News) website.
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ICRH-M was founded in 2009 with the mission to improve sexual and reproductive health in Mozambique.

Although the abortion law in Mozambique was liberalised in 2014, after so many years of a restrictive law being in place, knowledge about safe legal services remains low, and there are gaps in provision coverage and quality. ICRH-M's SAAF funded work focuses on two districts of Tete province in Central Mozambique, which has high levels of adolescent pregnancy and early marriage. The organisation will implement complementary interventions to reduce institutional and social barriers to safe abortion, and use this experience to contribute to learning on how to improve the effective implementation of safe abortion in ways that are accepted by health providers and communities. The project trains abortion providers and staff at district referral health centres, and introduces robust monitoring systems for quality services. ICRH-M also works with local communities (including training up female sex workers, and adolescents as activists) to ensure information about safe abortion services is available.

Visit the Centro Internacional para Saúde Reprodutiva (ICRH-M) website.
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Nigeria

Generation For Environ­mental Education and Enhanced Renewal (GREENER)

GREENER is a women-led community based organisation which aims to promote access to sexual and reproductive health and rights (SRHR), sustainable environment, and social justice for women and girls in the Niger Delta region of Nigeria with a particular focus on vulnerable, economically marginalized and socially disadvantaged women and girls in remote rural riverine communities.

GREENER’s SAAF funded work is focused on reducing harm faced by women living in these remote communities, where the lack of quality and accessible healthcare combined with deep rooted stigma means that many women are forced to resort to unsafe methods to end pregnancies. Staff from pharmacies and health clinics are trained on non-judgemental pregnancy counselling, administration of medication for safe abortion care, and post abortion care including contraception. Women and girls in the community are also trained as ‘change agents’ to raise awareness about reproductive rights, break down myths and misinformation, and where appropriate, refer their peers to services. They also share information about GREENER’s free transport service to access contraceptive services from public health facilities in the larger cities.
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Nigeria

Inter­national Centre for Poverty Alleviation and Sustainable Development (CENPAD)

Women and girls living in the Internally Displaced Peoples Camps in North-East Nigeria are at great risk of rape and sexual assault and many are forced to trade sex for material gains, or food. Due to lack of access to either contraception or safe abortion, this leads to disproportionally high rates of unsafe abortion and consequent injury and death.

Using SAAF funding, CENPAD aims at reducing this by using a harm reduction approach to ensure that women and girls have improved knowledge and access information on menstrual regulation through medication, alongside increased access and uptake of post-abortion contraception. Thereby ensuring that the women and girls whose rights have already been violated are not further violated by forced pregnancy, death or disability.
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In Nigeria, 13% of maternal deaths are attributable to unsafe abortions and an estimated 1 in 12 women have undergone an unsafe abortion. Having received SAAF funding to support their work since 2014, WFI has adopted an innovative public-private facility cluster model which built the capacity of midwives from government-funded midwifery service scheme for post-abortion care as part of comprehensive sexual health services. Male advocates and local media troupes were trained and communities were mobilized to reduce barriers to service access.

WFI is now building the capacity of a new cohort of providers and training youth peer provider to mobilize youth across the Federal Capital Territory. This will expand and sustain access to post-abortion care, safe abortion and post-procedure contraception to reduce maternal mortality and morbidity resulting from unwanted pregnancy, unsafe abortion and its complications.

Visit the Women Friendly Initiative (WFI) website.
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Regional

Mama Network

The Mobilizing Activists around Medical Abortion in Sub-Saharan Africa (MAMA Network) was founded in 2016 as a regional network aimed at strengthening collaborative relationships between groups of grassroots activists working to expand access to medical abortion in the region.

Under this SAAF supported project the MAMA network works collaboratively with Women Help Women and Ibis Reproductive Health to run a research study aimed at expanding the evidence base on safe self-use of medical abortion by documenting attitudes, decision-making and effectiveness in Sub-Saharan Africa. It also builds the capacity of MAMA Network members to ensure standardized and systematic data collection, analysis, and dissemination within the Network, as well as both regionally and globally. By doing so, the aim is that members will be able to compare impact between countries and contexts, identify best practices, modify and improve their approaches, and strengthen the evidence for shared strategies to increase access to safe abortion through community activism.

Visit the Mama Network website.
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Though there is public and parliamentary support for a more liberal abortion law in Sierra Leone, the former president refused to sign the 'Safe Abortion Bill'. Consequently, the extremely restrictive '1861 Offences Against the Person Act', a hangover from British Colonialism, still stands, bringing with it the high maternal mortality rates which come with restrictions on safe legal abortion. A few NGOs and hospitals with trained personnel perform post-abortion care after a woman has had a miscarriage or an unsafe abortion.

Women’s Health and Reproductive Rights Organization (WHRRO) works with 20 rural communities in Sierra Leone to move towards a reduction of unsafe abortion through education and awareness raising. Activities include training community health care workers on post-abortion care and harm reduction methods, as well as sharing accurate information on safe abortion and SRHR with the public through radio shows and theatre performances.

Visit the Women’s Health and Reproductive Rights Organization (WHRRO) website.
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Based in Puntland, Somalia, SGJ works to achieve gender equality and social transformation, using evidence-based approaches. Their SAAF funded work takes a gender-transformative approach to ‘Break the Silence’ on improving access to safe abortion services for survivors of sexual violence.

Sexual violence occurs in epidemic proportions, though is poorly documented, rendering its impact on victims invisible and creating an atmosphere of non-accountability. Abortion, where it is available, is permitted only to save the life of a woman, and health workers, fearing repercussion, may in practice be reticent to refer survivors or provide abortion in any context. SGJ aims to decrease stigma through normative and policy change for survivors of sexual assault accessing safe abortion services.

Visit the Somali Gender Justice website.
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Despite South Africa’s liberal abortion laws, abortion is still a contentious issue and women face several barriers accessing care. One major barrier is lack of public health facilities which provide this care. Nurses working in abortion care report experiencing stigma and discouragement from management, colleagues and their communities. They often experience isolation and burn-out, contributing to absenteeism and poor retention.

In order to mitigate this challenge, The Health Foundation works with the Department of Health to increase the acceptability and availability of abortion care in a rural district of the Western Cape by addressing staff and management attitudes towards abortion through Values Clarification Workshops, increasing service capacity by training and mentoring new providers, improving retention through debriefing and peer support, increasing awareness among surrounding communities about the availability of abortion care services and increasing the sustainability of these initiatives by training and mentoring health department staff.

Visit the Western Cape Health Foundation website.
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The Association of Obstetricians and Gynecologists of Uganda (AOGU) is professional organization founded in 1985 with the mandate to promote professionalism, undertake research, represent its members at local, regional, international level, as well as champion Sexual Reproductive Health and Rights of the people in the region.

Unsafe abortions contribute approximately a third of all maternal deaths in Uganda. AOGU's work aims to use the harm reduction model to reduce abortion related morbidity and mortality among young women by preventing unwanted pregnancies through improved access to post abortion care, post-abortion counselling and uptake of contraception.

Visit the Association of Obstetricians and Gynaecologists of Uganda (AOGU) website.
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The Center for Health, Human Rights and Development (CEHURD) is an indigenous, non-profit, research and advocacy organisation, which is pioneering the enforcement of human rights and access to justice in relation to the right to health in Uganda.

CEHURD has been supported by SAAF since 2014. They currently endeavour to ensure that there is a strong legal defense of harm reduction which can provide reassurance to providers of safe abortion care within the restrictive legal environment in Uganda. CEHURD also plan to strengthen the legal guidance on the concept of consent to treatment as it applies to Sexual and Reproductive Health to reduce incarceration of nurses and midwives for providing abortion care and enhance legal arguments for defending suppliers of abortifacients from prosecution to increase availability of safe abortion supplies to women in need.

Visit the Center for Health, Human Rights and Development (CEHURD) website.
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Kyetume has been running an Emergency Post Abortion Care Project with SAAF funding since 2011. Through its main health facility and five partner clinics, the organisation provides safe post-abortion care and other sexual and reproductive health services to women in their community in order to decrease abortion-related complications. They also work with community volunteers to promote safe post-abortion care services and improve voluntary uptake of post-abortion contraception.

Under this project, they intend to increase support for their abortion-related services amongst district level stakeholders and policy makers of Kakumiro- Kibaale district. Increase access to quality abortion-related services for women and girls in the Kyakuterekera parish and increase knowledge and change attitudes towards abortion in the community of Bugangayizi, Kakumiro- Kibaale district.

Visit the Kyetume Community Based Health Care Programme website.
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Lady Mermaid's Bureau is a small sex-workers rights organisation based in Kampala. They started their SAAF supported project in 2014 and since the start of the project have trained thousands of sex-workers across eleven towns with information about their rights and how to avoid unsafe abortion.

You can read some stories from their project in the SAAF stories page.

Visit the Lady Mermaid’s Bureau website.
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Uganda

St. Augustine Community Health Centre

St. Augustine Community Health Centre (SACH) is a not-for-profit organization dedicated to building healthier and prosperous communities in Western Uganda. The centre uses primary health care approach to meet high demand for basic health services. This is done using an integrated model to deliver holistic health care services and build capacity of communities to empower them to meet their health needs through community mobilization and sensitization on health issues, training and support to village health workers and other community leaders and linking communities to external supporters.

With SAAF funding, they work to improve knowledge about abortion issues, increase access to abortion-related care and improve attitudes and beliefs of community members towards abortion in the Mbarara District.
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COHERINET was founded as a network of activists aiming to increase information on the safe use of medical abortion in Uganda.

Using SAAF funding, COHERINET works to empower women by increasing their knowledge about safe abortion with pills by maintaining the Aunt Kaki sexual health hotline. It also implements community level strategies to advance the roles of lay health workers and promote the hotline widely among particularly vulnerable groups. The project improves the operating environment for safe medical abortion service providers by sensitizing Ministry of Health officials, law enforcement officers and human rights organisations on sexual reproductive health rights.

Visit the The Community Health Rights Network (COHERINET) website.
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Working in the marginalised slum areas of Kampala the community based initiative, Tusitukirewamu Group, works to improve the lives of young women involved in sex work and in and out of school youth living in densely populated urban slums. Gender inequality, poverty and sexual violence are endemic and many of these young women lack information on contraception and STI prevention, which causes unintended pregnancies and hence unsafe abortions.

Following on from succesful SAAF supported projects, Tusitukirewamu continues to work with peer educators and outreach workers in the community to increase awareness on the availability of high quality abortion and contraceptive services. They support local health facilities so that they are able to provide safe abortion and post-abortion care using modern techniques and promote women’s rights and health seeking behaviour through online and offline activities, as a way of soliciting for support to fight abortion stigma, unsafe abortions and GBV cases.

Visit the Tusitukirewamu Group website.
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Uganda

Volunteers for Development Association in Uganda (VODA Uganda)

Girls and women in rural Uganda face extreme gender inequality which is a cause and consequence of the high levels of sexual exploitation, incest and violence faced by many young girls and women. Young people have little access to sexual and reproductive health services and abortion is highly restricted.

VODA Uganda empower young people as change-makers in their schools and communities. Unsafe abortion was once a widespread problem in the area but through the power of peer education and by working with community leaders as well as youth, community attitudes toward abortion have been transformed. Deaths due to unsafe abortion have almost disappeared and community leaders and health providers are now calling for safe abortion to be made available for more young women in need.

You can read more about this project on the SAAF stories page.
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Copper Rose Zambia envisions a world in which every woman, girl and young person is happy, healthy and living to their full potential.

Although Zambia’s abortion law is liberal in comparison with many other African countries, unsafe abortions are still common. Noting that adolescents and young women are those most likely to be affected by a lack of access to safe abortion services, Copper Rose Zambia (CRZ) has created the ‘Safe Reproductive Health Awareness Project’ focused in the Petauke and Nyimba districts in the Eastern province of the country.

They work on increasing awareness of the legal status of abortion amongst service providers, policy makers and traditional leaders, as well as young women aged 15-24. As well as providing training and information to these groups, CRZ connects service providers with trained ‘teen connectors’ in the two districts, to ensure a smooth referral process for girls seeking to access safe abortion and other sexual and reproductive health services.

Visit the Copper Rose Zambia website.
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