1. European Board and College of Obstetrics and Gynaecology
Tackling Inequality in Access To Contraception In Europe
International Session of EBCOG/TSOG/UNFPA- SRH Issues and Women’s Rights
Dr Tahir Mahmood CBE
MD, FRCPI, MBA, FACOG,FRCPE, FRCOG
President EBCOG
18th May, 2017
Antalya
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Challenges
Inequitable access to all forms of contraception
Inequality in access to long acting contraceptives
Inequality in access to abortion service provision either Surgical or Medical methods
And the fall out in some countries: is high teenage pregnancy rates and High maternal mortality rates
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3. International Session 18052017
Taking stock - End of 2015
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Rolled into SDG 3

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6. Total methods across Europe
Pill #
28%
Hormonal implant 1%
Contraceptive patch
Injectable
Vaginal ring
Intrauterine system 3%
Copper intrauterine device 5%
Male condom (as only method)
17%
Other methods *
18%
No method
25%
# Not for emergency contraception
* Include emergency contraception, vasectomy and methods regarded as being less reliable such as cap, diaphragm, female condom,
spermicides, natural methods (basal temperature, rhythm/calendar method, withdrawal), and Persona ®
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7. Unmet needs for Contraception In EECA Region
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Unmet need for Contraception leads to untimed Pregnancy, thus needs access to Abortion Services
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12. Percentage of pregnancies ending as abortion
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14. Abortion Provision Globally
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15. Abortion law around the world- Progress and Pushback
68- Countries currently prohibits abortion entirely or permits it only to save a women’s life
60- Countries allow a women to decide whether to terminate a pregnancy
57- Countries permit abortion to protect a women’s life and health
14- Countries permit abortion for socio-economic motives
39% of the world population lives in countries with highly restrictive laws governing abortion (Finer and Fine, 2013)
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16. Do women have a choice in all countries of Europe?
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18. Access to Abortion in Europe
Countries with more restrictive legislation-4
Permit on socio-economic grounds- 4
Available on request with compulsory waiting and Counselling -7
Countries with liberal legislation (up to 12 weeks) - 21
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19. How to improve Sexual and Reproductive Health of the Women ?
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20. Multi-faceted Approach
Working with Organisations which can make a difference
Understanding what works?
Promoting availability of all effective methods of contraception including access to abortion
Focusing on the totality of Sexual Health of Women as overall package
Role of EBCOG and the National Societies
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22. WHO Europe Action Plan for Sexual and Reproductive Health 2030
Provision of information and services that enable people to make informed decisions about contraception
Prevent sexual violence and exploitation
Reduce unmet needs for contraception by removing medical barriers to contraception
Reduce STI by providing dynamic preventive and curative services
That abortion services offer comprehensive information
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24. Advocatıng A Comprehensıve Sexual and Reproductive Health Strategy
A comprehensive strategy of Capacity Building,
Integrated Service delivery model for family Planning and Pregnancy Care at the Primary care Level to meet the local needs (Long Acting contraceptives, Post coital contraception and Sex Education in Schools)
Full provision of family Planning Services will add value to overall wellbeing of Women and the Society.
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Percentage of women experiencing an unintended pregnancy within the first year of use (Pearl index)
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27. Effective access to contraception reduces abortion rate-Ukraine
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28. Access to Medical Abortion as an Outpatient Procedure
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29. Measurable benefits of investing in Family Planning Services
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30. Factors contributing to the improvements for the use of contraceptive methods
Training, Knowledge and skills by UNFPA/EBCOG
Capacity Building and Communication
National Society/Academic Institutions
Political/Legal Framework committed to FP
Adequate funding committed
Capacity Building for SRH Professionals
Individual user
Govt. Policy for sexual and reproductive rights
Advocacy for SRH strategy
Socioeconomic and sociocultural system.
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