ICMA January 2011 NEWS Newsletter n.4

Asia Safe Partnership Latin American Consortium Eastern European Alliance African Network Against For Reproductive Choice for

As part of ICMA´s commitment with women´s right to safe and legal abortion and convinced of the need to strengthen collaboration and share expertise and views among global stakeholders, we have invited to join this number of our Newsletter to address one of the most promising topics in the abortion field: the hotline strategy as a mean to guarantee the rigth to information and to put the abortion process into women´s hands.

“Hello, do you need information about safe abortion?” Hotlines on in countries with restrictive laws

By Kinga Jelinska, Project Manager, Women on Web

Since 2008, Women on Waves and Women The campaigns usually involve non-medical on Web have been supporting local groups in professionals. Safe abortion traditionally creating hotlines that provide information on belongs in the spectrum of knowledge and how to do a safe abortion and how to safely expertise of medical professionals. Abortion self-administer misoprostol. Those hotlines with pills brings a new paradigm; the process run in countries where access to safe abortion is very similar to a spontaneous miscarriage, it services is restricted. Since 2008 local groups is an easy procedure that can be safely done in Ecuador, Chile, Argentina and Peru launched by women themselves if they have reliable the hotlines. In 2010 WoW together to a instructions. The information needs to spread regional ICMA network, Asia Safe Abortion also outside the routine channels of doctors Partnership, worked with local groups in and mid-level health professionals and get Pakistan. into women’s hands. Some of the groups that launched the hotlines were youth feminist Women on Web and Waves for several years groups, fighting for women’s autonomy, but have been running a multilingual email not necessarily working exclusively on repro- helpdesk. In 2010 alone WoW sent 70 000 ductive health issues. Other partners were emails to women from all around the world, LGBT groups. In Latin America the groups cre- advising them on how to do a medical abor- ated a regional network and it is hoped that tion, particularly in contexts where abortion is in 2011 the activists will be able to meet on legally restricted. Through the Women on Web the global level with support of the ICMA. website, women that need the medicines can get both and misoprostol sent The hotlines give detailed, practical informa- to them discretely in a courier package. How- tion how to do an abortion with pills, what to ever, access to the Internet in some regions expect, what are the possible complications. remains problematic. To bridge the digital Unsafe abortion does not affect everyone divide and compliment the online work, WoW equally. Women with financial means can works with partners on the ground using always find a way to travel or find a doctor. different strategies, like mobile phones, SMS, The injuries and deaths due to unsafe abor- and word of mouth campaigns, with the goal tion are overwhelming – it’s as if every day of building awareness about misoprostol, a a whole plane crashed, a plane filled only medicine often available locally. with women. This happens purely due to bad laws and stigma, and this tragedy is totally preventable.

ICMA NEWSLETTER n.4 | JANUARY, 2011 Page 1 Misoprostol, for many women, is the safest and most often also protected by national constitu- their most basic right to information? Even if it is certainly the cheapest option available locally. tions. The information provided by hotlines is often the safest possible options and it should be Moreover, an abortion with pills is indistinguish- based on the official protocols of the World Health the woman herself to decide what is best for her? able from a spontaneous miscarriage, so there is Organization. no risk of prosecution for the woman to go to the The aura of fear hangs over popularization of doctor, if she does not mention the pills herself. Despite the WHO protocols and practice, some information about the pills for abortion and bring- This is as well a crucial piece of information given doctors and advocates believe the pill does no ing it to the community level and to the women to the callers. magic for women. The controversy brings argu- themselves. This fear mandates that the knowl- ments like: it is not the optimal solution, it is not edge about misoprostol should rather remain out Furthermore, research proves that misoprostol as effective as in combination with mifepristone, of public view and should be over-medicalized. can cut the risk of postpartum hemorrhage (the it can be used also for longer pregnancy termina- Concerns regarding not easily accountable foremost cause of maternal mortality) in half. tion, women can misdiagnose or lie, incomplete outcomes, political backlashes and the govern- Women who will not deliver with a skilled birth will need further treatment and it is mental reactions function as an excuse for not attendant can self-administer misoprostol for safe always better if the doctor supervises the process. talking loudly about misoprostol. The possibility birth. Misoprostol is therefore nothing less than a It’s a long list of smaller and bigger “buts” and of medication being restricted by the government miracle for women’s health. objections. Due to this potentiality of misoprostol can be predicted, and the conflicting agendas can being used in the not utmost correct manner, be strategically challenged. The hotlines, as well as Women on Web’s online some think it is better to hide the misoprostol help service, use the harm reduction model with option altogether from broader public. Should the The difficulty with letting go of the control over the aim of diminishing the mortality from unsafe potentiality that a few women might not obtained this information, and letting it flow into public abortion. From the public health perspective the most desired result get the precedence over domain probably has to do with the very potential awareness about available options, like misopr- of the technology, as well as the issue of trust ostol, are beneficial and live-saving for women’s in women and in their autonomy. We should not health. The hotlines are protect women from any information, or protect women from themselves. It’s up to individuals But it were not public health scientists or activ- determined to get the how they are going to use information. And they ists that stimulated the use misoprostol. Since word out there. have the moral right to use it in any way they the eighties women in Latin America have been want. purchasing the drug and taking it, way before the Hotline in Argentina: 011 156 664 7070 protocols and recommendations were sanctioned The manifesto of the misoprostol hotlines is by research. Still today there is way not enough Hotline in Chile: 08-8918590 straightforward and optimistic. They document the information easily available to women in need, barriers to access, but at the same time the solu- and some women keep on using incorrect proto- Hotline In Ecuador: (593) 098301317 tions and empowerment of resourceful women cols or buy false medication. In Pakistan the tab- that found a safe option and benefitted from it. Hotline in Peru: 01-945411951 lets are cheap and very accessible even without Some of the groups use very creative way of prescription, but unlike in Latin America, very few Hotline in Pakistan: disseminating the information – they do grafit- women, if any, knew about their existence. The 0307 - 494 07 07 - (Urdu, Punjabi) tis in the cities, they use online networks like magic pill is there, but it’s just not yet used to its facebook to pass on the message, they campaign full potential, because of the information deficit. 0315 - 917 04 08 - (Urdu, Pastho) at pop festivals or stamp money with the hotline numbers. For example the Lesbians and Feminists In essence, the right to information is the legal 0315 - 947 33 99 - (Urdu, Sindhi) for the Depenalization of rationale of the hotline projects. The right to published a book that gathers everything you information and the right to enjoy the benefits For more information: want to know about abortion with pills. It was of scientific progress are guaranteed not only by [email protected] distributed with a local newspaper. And the pills human rights treaties ratified by governments but on the cover have very smiley faces.

Public Opinion on abortion in Latin American countries: broad consensus for public debate on depenalization of abortion Claudia Dides, M. Cristina Benavente, Isabel Sáez Programa Inclusión Social y Género, FLACSO-Chile The results of the opinion poll on abortion Consequently in Brazil, Chile, Mexico and Nicara- sions is that it is posible to discern attitudes conducted by the Gender Program of the Latin gua, the population supports more flexibility on supporting penalization and depenaliza- American Faculty of Social Sciences, Chile abortion laws in certain circumstances, such as for tion (absolute or relative) not only across (FLACSO-Chile) in Brazil, Chile, Mexico and example when the life of the women is in danger sociocultural and socioeconomic conditions Nicaragua in 2009, reveal that the majority (66 per cent on average), in cases of rape (56 per that affect value scales from conservative of the population favour depenalization of cent on average) or in case of fetal malforma- to liberal, but also according to respond- abortion under certain critical circumstances. tion (61 per cent on average). A common feature ent’s life experiences. Personal proximity to There is a broad consensus in the 4 countries in the four countries polled is that people want women who have endured difficult pregnancy that abortion is a serious problem in itself more flexibility in laws penalizing abortion and circumstances (losses, unwanted pregnancies, (82.5 per cent on average), supported by the ask for greater participation in the debate and the unwanted children or abortions) influences perception that a large number of women in decisions related to these laws. Evidently, these their attitudes on abortion and indicates the these countries die as a result of an abortion. societies are demanding more democratization of presence of individual motivation, distinct Respondents also perceive (78 per cent) that the debate and of decisions related to abortion, from ideology or value systems, in supporting women who live in poverty have a greater bringing it out of the exclusive sphere of the abortion under certain circumstances. risk of resorting to unsafe abortions. elites. Finally, one of the most relevant conclu- For more information: www.flacso.cl

ICMA NEWSLETTER n.4 | JANUARY, 2011 Page 2 Making mifepristone available and accessible in Latin America Dan Grossman, Senior Associate, Ibis Reproductive Health Member of the Coordinating Committee, CLACAI

Misoprostol has had a profound impact in Latin there is evidence supporting its use for missed Concept Foundation and Linepharma are interested America, where the drug’s availability in pharma- abortion (or anembryonic pregnancy) and for in working with local NGOs as well as government cies has greatly improved access to a safe method induction in cases of fetal death. Some of these bodies to register these products. of abortion. Around 40 products containing indications may be more feasible in countries with misoprostol are registered in the region, mostly for restrictive abortion laws—especially if abortion is Registering mifepristone in Latin America will not the prevention and treatment of gastric ulcers, al- allowed in cases of fetal malformation or threats be easy. We can expect to confront strong anti- though in a few countries misoprostol is registered to the woman’s health, indications that are often choice resistance, as well as a lack of knowledge, for obstetric indications such as labor induction. diagnosed in the second trimester. among governmental officials, including the And while this is an important advance over less national bodies that oversee the drug regulatory safe abortion methods, is it good enough? Or The pathway to registration of mifepristone may process. It will be important to be prepared with should we be working to gain access to mifepris- vary from country to country. In some countries, the ample evidence demonstrating mifepristone’s tone, the gold standard medical abortion drug? it may be possible to register the drug based on safety, efficacy and acceptability in order to published data from other countries, while in oth- combat arguments based more on opinion than When used alone, misoprostol can be effective ers it may be necessary to perform a clinical trial in science. We might also find resistance on the part in up to 85-90% of cases to induce a complete the country. In Mexico City, for example, Gynuity of the pharmaceutical industry, which sees a low abortion, meaning that at least 10-15% of women Health Projects is working with the Ministry of potential for profit from mifepristone in the region. will require an aspiration procedure (such as MVA). Health to perform an introductory study using an Similar challenges might be encountered trying to The proportion of women who end up having an evidence-based mifepristone regimen in public find a local distributor of the drug. It is heartening aspiration may be higher in practice, especially in sector facilities. One of the primary goals of the to see a few pharmaceutical entities interested in settings where abortion is legally restricted and study is to generate data that could be used for making this drug available at an accessible price, services operate clandestinely. When mifepristone registration purposes. The commitment and sup- and in many countries it might be possible for local is used with misoprostol in the combined regimen, port on the part of the Mexico City governmental NGOs to act as the distributor. the efficacy increases to 95-98%. For this reason, officials have been critical to obtaining the neces- the combined regimen is recommended by the sary approvals to perform this research. Mifepristone is no longer a drug that only World Health Organization, which added both women in wealthy countries can access—it is now medications to its model list of essential medicines Adding mifepristone (along with misoprostol) to registered in many developing countries such in 2005. the list of national essential medicines or including as Cambodia, India, Nepal, South Africa, Tunisia, it in national clinical practice norms or guidelines Vietnam and Zambia. And while there are still Mifepristone has been registered in over 45 can also be important steps toward gaining ac- challenges to make this method available in the countries worldwide, yet only one country in cess to the combined regimen. For example, in public sector in some of these countries, it is clear Latin America—Guyana—has registered it so far. Colombia, the national norms regarding voluntary that important advances are being made toward However, recent legislative changes in the region pregnancy termination refer to the mifepristone bringing the most effective medical abortion may facilitate mifepristone’s registration in the regimen and recommend its use once the drug regimen to the women who need it most. Such near future. In 2006, the Colombian Constitutional is registered. More work needs to be done to advances have not yet been seen in Latin America, Court issued a ruling that liberalized the country’s educate policy makers in other countries about the and it is important that advocates, researchers and by allowing termination of pregnancy efficacy of the mifepristone regimen. clinicians put the issue of access to mifepristone in cases of rape or incest, fetal anomalies, and onto the safe abortion agenda in the region. It is when the pregnancy threatens the life or health But what about the cost of the drug? Mifepristone no longer sufficient to say that the legal restric- of the woman. And in 2007, the legislature of the is exceedingly expensive in the United States, tions on abortion justify the lack of access to Federal District of Mexico City passed a law that costing almost $100 per 200 mg tablet (only one this drug, since abortion is legal for at least one legalized abortion up to 12 weeks’ gestation, and tablet is needed per woman). And while the indication in almost all countries in the region. almost immediately services were established in drug can be very inexpensive in India, few Indian Just like all women everywhere, Latin American city-supported hospitals. In both countries efforts manufacturers have been interested in market- women deserve to have access to the safest, most are underway that could lead to the registration of ing the drug in Latin America at a similar price. effective method to terminate their pregnancies mifepristone. However, over the past few years, at least two when they decide to do so. low-cost, high-quality mifepristone products have These legislative changes may make registration of become available that could be registered in Latin For more information: mifepristone more attractive to a pharmaceutical America. Concept Foundation has been working company because of the larger demand for the to develop and register Medabon®, a combined Medabon®: http://www.medabon.info/ product. Certainly the perceived limited demand mifepristone-misoprostol product manufactured in countries where abortion is legally restricted by Sun Pharmaceutical Industries in India. Another Linepharma mifepristone: discourages many companies from pursuing regis- mifepristone product manufactured in Europe by email: [email protected] tration. However, it is important to note that the Linepharma was recently approved in five Scan- mifepristone regimen is also the preferred method dinavian countries. These products aim to have a Gynuity Health Projects: www.gynuity.org for second-trimester induction termination, and public sector price below $11 per tablet, and both or email [email protected]

ICMA NEWSLETTER n.4 | JANUARY, 2011 Page 3 Advocacy with the mass media for gender sensitive and rights based reporting of SRHR issues By Suchitra Dalvie, ASAP´s Coordinator

The issues related to sexual and reproductive and several recommendations for further improve- In Malaysia, there were about 20 participants health and rights and abortion in particular is usu- ment from both sides were drawn. from NGOs but there were only 3 press reporters ally not dealt with by the mass media in a gender and 2 were feature writers. sensitive way or with a rights based approach. Of- In Vietnam, there were 10 journalists attending ten misleading or sensational information is given this workshop from seven newspapers in Hanoi The pre-forum statement was published in two which can increase the perceived stigmatization of and Ha Nam and one national TV channel. The national papers Sun and Star. There was also a the women involved. Youtube interview of Rashidah Abdullah Co-Chair of the Advocacy Alliance Journalists and reporters on the ‘health beat’ or Malaysia (RRAAM). She spoke on the “Abandoned ‘women’s issues’ are rarely oriented to the social babies in Malaysia: Dispelling the myths” which constructs or rights perspective of these issues covered unintended pregnancies and rights to and there is little effort for capacity building since accessing contraception and abortions in Malaysia these are usually temporary postings and often for on Malaysiakini.TV an online paper. She further junior staff. cleared the doubts about abortion in Islam religion by stating “...in Islam, abortion is allowed up to In 2010, Asia Safe Abortion Partnership (ASAP) participants were also updated about unsafe abor- 4 months, when the soul is regarded as entering arranged three media sensitization workshops tion and its negative consequences in the world, the foetus, so it not regarded as alive, so it’s not along with the local partners in Nepal, Vietnam in Asia and in Vietnam specifically. Issues related a sin,...” . and Malaysia. In Nepal it was arranged with to adolescents’ abortion were deeply discussed. National Media Development Center (NMDC), in Medical abortion was also discussed with specific coordination with Family Health Division/Ipas reference to young women. Nepal, Ministry of Health and Population; in Viet- nam with Concept Foundation and the Centre of A field visit was also arranged to see the clinic Research and Action for Community (REACOM) and facilities on the last day of workshop at the Ha in Malaysia it was arranged with the Reproductive Nam Provincial Reproductive Health Center. At this Rights Advocacy Alliance of Malaysia (RRAAM). center the journalists had chance to observer an MVA case, acting as a client for a contraceptive These media sensitization workshops were counseling and interviewing health providers. The conducted to orient journalists on the gender and observed abortion case was very friendly and fol- rights dimensions of safe abortion issues. They lowing Vietnam national standards and guidelines were designed to address the key issues of Sexual for safe abortion service. Achievements of these workshops: & Reproductive Health Rights and safe abortion and to empower media persons by providing them They also participated in a youth club activity We learnt that mass media can play a significant with sufficient reference material, information at Boi Cau Commune, Binh Luc District, Ha role on disseminating sensitive and accurate and techniques for reporting on gender, Sexual & nam. reproductive health information and create a very Reproductive Health Rights and abortion. supportive environment for safe abortion issues.

Sessions included values clarification, myths and Health reporters clearly understood different misconceptions, law related to safe abortion in features, aspects, social dimensions and impact the country etc. Articles were printed in the local of Gender and SRHR Rights, Abortion, MA and newspapers in both countries as a follow up to the concerned Laws. workshop. The journalists and service providers both realized For the Nepal workshop there were 17 health that there is a need to increase the reporting reporters from –TV, radio and broadsheet dailies. capacity and knowledge on gender-heath of the There were 7 women journalists. The work- reporters and a commitment of the journalists shop reference materials, presentations of the for in-depth and analytical gender health news expertise of the resource persons, the study data These visits helped the journalists to understand publication. encouraged the journalists to think about bring- and develop linkages with learning from the ing in-depth and follow-up stories on Sexual & workshop and the life experiences. These sowed Many national newspapers covered news about Reproductive Health Rights. many ideas for their future articles for the journal- the workshop and the content from the workshop ists. They experienced that the young people at in their respective local newspaper. Also news and All presentations were focused on gender health, the community have very poor knowledge about interview with the resource persons were covered health rights, safe abortion, news reporting Sexual & Reproductive Health Rights, contracep- on different FM radios in Nepal and on an online trends, and importance and value of accurate and tion and safe abortion and there is a need to newspaper in Malaysia. credible information. Technical difficulties of re- emphasize on these issues through newspaper porters and service providers were also discussed releases.

ICMA NEWSLETTER n.4 | JANUARY, 2011 Page 4 Challenges and Perspectives in Advocacy for Safe Abortion By Daniela Draghici, Eastern European Alliance for Reproductive Choice (EEARC)

Eastern Europe is a region where abortion rates of Albania and Romania, but since the collapse unrestricted access to safe abortion, including remain high, despite efforts to secure contracep- of communism in the 1990s abortion discussions medical abortion, if she chooses to do so. Our goal tive supplies and encourage use. Medical abortion have increasingly been framed in ideological and is to help reduce maternal mortality by increasing drugs are registered in several EE countries; religious terms and this has had an impact on the access to safe abortion, with focus on Medi- nevertheless, access to this method is very accessibility of information and services. Just one cal Abortion (MA). Our objective is to enhance limited. Access to abortion services has been example: Poland, where abortion became crimi- regional advocacy capacity to raise awareness, challenged in recent years because of concerns nalized in 2003 and it has been so ever since. sensitize providers, and motivate women to about declining birth rates, pressure from religious embrace MA. The Alliance is actively increasing its groups have further reduced support for abortion Just one striking information from Hungary. The membership and promotes exchange of advocacy and contraception. Parliament is planning to introduce the protection strategies and educational materials across the of the fetus from conception into their constitu- network. Through presentations at national and Abortion politics has also affected access to tion. Hungarian activists believe the threat is international conferences, members of EEARC medical abortion in Central and Eastern Europe. really serious, as the leading Christian party that have raised awareness about the need for better In Latvia, the procedure proved burdensome to introduced the draft holds the majority and, access to MA, especially to audiences of providers women, since they were required to stay in an ap- together with another right wing party, they can and women’s organizers. Providers and women’s proved facility for the duration of the procedure or really do what they want. Hungarian activists organizations are the main audience in advocating up to ten days, and were subsequently subjected seem to be completely unprepared. They have not for better access to MA at regional and interna- to ultrasound in order to confirm completion of worked on reproductive rights for a long time as tional level. the abortion. In , drug approval was op- they did not see that as being necessary. posed by the Catholic Church and the Ministry of EEARC has undertaken strategic assessments of Health, and a study commissioned by the Ministry Sexual and reproductive health and rights are policies regarding abortion and contraception in of Health concluded that Mifepristone posed areas of special concern in Central and Eastern Romania, Moldova, Ukraine, and Russia, which a health risk to women and could potentially Europe and Central Asia. Women of our region have shown the real dimension of these issues increase the national suicide rate. While the drug face many barriers in accessing satisfactory re- among service providers, clients, decision-makers, is also registered under various labels in Albania, productive health services and in exercising their and the community as a whole, and have broken Armenia, Azerbaijan, Belarus, Estonia, Georgia, reproductive rights to free and informed decisions the taboo around these issues. These have been Hungary, Latvia, the Republic of Moldova, the Rus- concerning reproductive choice. That is due to the the only tools apt to cause policy change. Such sian Federation, Serbia, and Ukraine, Uzbekistan, it low priority given by governments to the issues changes, though, must be sustained by both was previously not offered. Among the European of reproductive and sexual health and rights, as public and civil society forces in order to have states that have approved Mifepristone, Estonia, well as to the growing influence of anti-choice, effect and lasting impact. The results have been Latvia, Moldova, Ukraine, Albania, Romania, conservative forces representing the so-called disseminated via the website and media chan- Serbia, and Russia have either physician-only or “traditional values”. Health and legal professionals nels, to raise awareness with the media and the obstetrician-gynecologist-only provisions in their are becoming more and more conservative. While population at large, and prepare the groundwork general abortion laws or national penal codes. In abortion may be legally acceptable, health profes- for the advocacy actions lying ahead. Country countries with restrictive abortion laws such as sionals increasingly cite conscience as a reason profiles have been developed and updated for the Poland, the drugs Mifepristone and Misoprostol to withhold abortion, especially medical abortion Alliance member countries and can also be found are not registered for use as . that can be controlled by women themselves. on the website.

Sexual and reproductive health and rights, as well The Eastern European Alliance for Reproductive In order to increase knowledge and attitudes of as the right to reproductive choice are issues of Choice (EEARC) purports to raise awareness, providers, EEARC has recently conducted a TOT critical importance in Central and Eastern Europe sensitize providers, motivate women’s groups, workshop for 23 participants from the Rus- and Central Asia—crossing borders and transcend- develop new evidence-based training curricula, sian speaking Eastern European region, titled ing cultural differences. Women in this region and to improve access to and quality of safe abor- “Comprehensive Care of Unwanted Pregnancies“. are underrepresented in political and economic tion, including medical abortion services. EEARC An advocacy workshop is planned for 25 EEARC arenas, receive lower wages than men for equal has a multidisciplinary membership structure and steering committee and other key members to work, shoulder a large portion of responsibility for works to collect and disseminate evidence-based design a multi-country advocacy strategy, using childrearing and domestic work, and have weak information on safe abortion, including medical appropriate messages, including those to combat legal protection from harassment or violence. abortion, through country reports shared across anti-choice rhetoric. All of these trends are interrelated and they all the network. The Alliance is actively increasing its have women’s right to reproductive freedom as a membership and promotes exchange of advocacy References: www.reprochoice.org foundation. strategies and educational materials across the network. The Alliance is working as a catalyst to http://www.medicalabortionconsortium.org/ While the laws may allow for women’s access to coalesce advocacy efforts to counteract restric- abortion and contraception, the actual situation tions recently imposed by governments and http://www.medicalabortionconsortium.org/news/- militates against any easy and universal access. parliaments in CEE countries. achieving-excellence-in-abortion-care--1241.html Since the 1950s abortion has been legal and accessible in the 30 CEE states with the exception The vision of EEARC is for every woman to have http://www.astra.org.pl/

ICMA NEWSLETTER n.4 | JANUARY, 2011 Page 5 Workshop for expanding medical abortion access in Africa By Selma Hajri, ANMA´s Coordinator

The workshop organized by the African Network 3. To undertake value clarification activities at on Medical Abortion was held the 24th and 25th different levels to bring in attitudinal changes of November in Nairobi, Kenya. Forty participants from the East African sub-region met to share, 4. For advocacy and information dissemina- learn and discuss their experiences with medical tion: abortion (MA). The main objectives of the meeting were to analyze the regional and international • To remain vigilant and monitor anti-choice policy and legal environment; to share experi- movement in the face of emerging strong ences and knowledge on MA; to examine the opposition barriers to access to MA and how they have been addressed; and to discuss how to respond to 2. For service delivery : • To scale up evidence-based advocacy work those barriers in the region. The participants also through consolidated strategy and creative discussed the role of ANMA and its partners in the • To facilitate registration of MA drugs includ- pro-choice alliance rolling out MA in Africa. ing misoprostol for all indications • To provide appropriate information and Speakers and experts from the African countries • To use mid-level providers and pharmacists harmonised messages to target diverse were invited to present country –experiences, to increase access to MA in the framework audiences (women, service providers, and several NGOs like ICMA, Concept Foundation, of task-sharing advocates, policy makers) Gynuity Health Projects, Ibis Reproductive Health, Ipas and Ipas Alliance Africa, The Guttmacher • To advocate for the involvement of com- • To adapt existing materials where needed Institute, and Marie Stopes International, enriched munity providers in the access to MA for MA information. the workshop with their contributions . • To empower women and communities by 5. For networking: To foster ANMA’s increased The key messages of the meeting as summarized providing appropriate information and ac- engagement with other networks and its by the Chair of ANMA were as follows: cess to misoprostol members, and to increase contacts with gov- ernments to influence policy and practice. 1. For policy and law: to increase engage- • To build the capacities of providers at differ- ment with regional institutions to implement ent levels ANMA´s Chairperson, Getachew Bekele, closed the existing legal /policy instruments and to workshop with a take-away message incorporate MA in the public health policies • To focus on the neglected area of 2nd and systems trimester medical abortion “Put women at the centre of the work, and keep in mind that medical abortion is a woman and not a provider-dependent option . It is time to avoid the talk and do the work: Walk the Talk”.

to address the specific information needs MEDICAL ABORTION of women, women’s groups and organiza- tions and other NGOs, policymakers, and health care providers, particularly those in INFORMATION developing countries. It includes a sec- tion containing resources, publications and PACKAGE contacts, model leaflets and examples of educational materials and personal histories. Lack of knowledge about Medical Abortion is a strategic objective of ICMA and the It also includes a section for women who is widespread, not only among women regional networks affiliates. need an abortion. around the world but also among service providers, policymakers, pharmacists and ICMA Information Package provides com- To access the information package go to: the lay public. Informing these target groups prehensive information on Medical Abortion http://www.medicalabortionconsortium.org

ICMA NEWSLETTERFor more n.4 information| JANUARY, 2011 please visit: http://www.medicalabortionconsortium.org Page 6