Misoprostol: Challenging restrictive Laws & faiths in rural Tanzania WPC’s Experience Addressing Women’s Abortion Need in Rural Communities

Abortion in Tanzania Tanzania among East African countries leading in maternal deaths 13,000 maternal deaths annually of which 18% (2,340) from unsafe abortions Only 5% of health facilities provide post Abortion care Culturally unspoken and Taboo topic Strongly Influenced by religious Legally restricted (allowed only saving women’s life and mental health grounds but difficult access) Sources: - The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008 –

Abortion in Tanzania Women resort to unsafe abortion practices

Misoprostol in Tanzania Registered for PPH since 2007 Experimented in Government hospitals in 4 districts (Ifakara project) Now promoted & supported by government for PPH only But still unknown by community members, especially in rural settings Expensive in private sector

Analysis of local context Training of CAAS Mouth to mouth campaign Local pharmacy Development of chants Quick chart cards (thought-provoking questions) Informal panels/workshop during national networking events Alliance Building with health professionals (doctors, distributors) WPC Experience with Miso Successful strategies

WPC Experience with Miso Strategies at glance

WPC Experience with Miso Failure Strategies Stickers Landline phone

WPC Experience with Miso Fears, challenges & Solutions Safety and stigma issues v/s rights guaranteed in national policies (constitutional right to get & provide art 8; National health policy, Strategic plan to reduce maternal mortality), community health approach, PPH & registration of Miso as entry point Literacy issue v/s Translation of materials in local language Taboos & religious fundamentalism v/s PPH as entry point, exposure of consequences of unsafe abortion, putting discussion in the context of women sufferance, involvement of moderated religious actors, quick charts with thought-provoking questions Expensiveness of Miso v/s Opening of a local pharmacy, alliance with doctors and pharmacists Safety after abortion process v/s alliance with doctors for quick and easy referral

WPC Experience with Miso Fears and challenges (unresolved) Women’s poor economic power Stigma and fear Opposition Fake Misoprostol supplied Funding shortage Disinterest of CAAs No control of regimen (dosage)

Successes More WOW partners’ session Thanks for your Attention