Publication:
Comparative Situational Analysis of Comprehensive Abortion Care in Four Southern African Countries

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creativework.datePublishedReceived 14 Nov 2022, Accepted 18 May 2023, Published online: 05 Jun 2023
dc.contributor.authorMacleod, Catriona Ida
dc.contributor.authorReuvers, Megan
dc.contributor.authorReynolds, John Hunter
dc.contributor.authorLavelanet, Antonella
dc.contributor.authorDelate, Richard
dc.date.accessioned2025-01-08T20:18:19Z
dc.date.available2025-01-08T20:18:19Z
dc.date.issued2025-01-08
dc.description.abstractWe report on a comparative situational analysis of comprehensive abortion care (CAC) in Botswana, Eswatini, Lesotho and Namibia. We conducted systematic literature searches and country consultations and used a reparative health justice approach (with four dimensions) for the analysis. The following findings pertain to all four countries, except where indicated. Individual material dimension: pervasive gender-based violence (GBV); unmet need for contraception (15−17%); high HIV prevalence; poor abortion access for rape survivors; fees for sexual and reproductive health (SRH) services (Eswatini). Collective material dimension: no clear national budgeting for SRH; over-reliance on donor funding (Eswatini; Lesotho); no national CAC guidelines or guidance on legal abortion access; poor data collection and management systems; shortage and inequitable distribution of staff; few facilities providing abortion care. Individual symbolic dimension: gender norms justify GBV; stigma attached to both abortion and unwed or early pregnancies. Collective symbolic dimension: policy commitments to reducing unsafe abortion and to post-abortion care, but not to increasing access to legal abortion; inadequate research; contradictions in abortion legislation (Botswana); inadequate staff training in CAC. Political will to ensure CAC within the country’s legislation is required. Reparative health justice comparisons provide a powerful tool for foregrounding necessary policy and practice change.en
dc.identifier.citationGlobal Public Health
dc.identifier.doi10.1596/42641
dc.identifier.issn1744-1706
dc.identifier.urihttps://hdl.handle.net/10986/42641
dc.language.isoen_US
dc.publisherTaylor and Francis
dc.relation.ispartofseriesGlobal Public Health
dc.rightsCC BY-NC-ND 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/3.0/igo/
dc.subjectABORTION
dc.subjectPOST-ABORTION CARE
dc.subjectSOUTHERN AFRICA
dc.subjectREPRODUCTIVE JUSTICE
dc.titleComparative Situational Analysis of Comprehensive Abortion Care in Four Southern African Countriesen
dc.typeJournal Article
dspace.entity.typePublication
okr.associatedcontenthttps://www.tandfonline.com/doi/full/10.1080/17441692.2023.2217442 Journal website (version of record)
okr.date.disclosure2025-01-08
okr.date.doiregistration2025-04-14T11:49:56.364138Z
okr.doctypePublications & Research
okr.doctypePublications & Research::Journal Article
okr.externalcontentExternal Content
okr.identifier.doi10.1080/17441692.2023.2217442
okr.pagenumber2217442
okr.peerreviewAcademic Peer Review
okr.region.geographicalAfrica
okr.topicHealth, Nutrition and Population::Reproductive Health
okr.topicHealth, Nutrition and Population::Health Systems Development & Reform
okr.topicHealth, Nutrition and Population::Health and Poverty
okr.volume18(1)
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