Health, life and rights: a discourse analysis of a hybrid abortion regime in Tanzania

Abstract

Background Unsafe abortion continues to be a major hazard for maternal health in Sub-Saharan Africa, where abortion remains highly controversial and access to safe abortion services is unequally distributed. Although national abortion laws are central in indicating women’s potential for accessing safe abortion services, the character of an abortion law may alone say little about national discursive abortion landscapes and access scenarios. The article calls for the study and problematization of the relationship between legal abortion frameworks on the one hand, and discourses surrounding abortion on the other, in an attempt to move closer to an understanding of the complexity of factors that influence knowledge about and access to safer abortion services. With the restrictive abortion law in Tanzania as a starting point, the paper explores the ways in which the major global abortion discourses manifest themselves in the country and indicate potential implications of a hybrid abortion regime. Methods The study combined a review of major legal and policy documents on abortion, a review of publications on abortion in Tanzanian newspapers between 2000 and 2015 (300 articles), and 23 semi-structured qualitative interviews with representatives from central institutions and organizations engaged in policy- or practical work related to reproductive health. Results Tanzania’s abortion law is highly restrictive, but the discursive abortion landscape is diverse and is made manifest through legal- and policy documents and legal- and policy related disputes. The discourses were characterized by diverse frames of reference based in religion, public health and in human rights-based values, and as such reflect the major global discourses. Fairclough’s concepts interdiscursivity and recontextualization were drawn upon to develop an understanding of how the concepts health, rights and life emerge across the discourses, but are employed in contrasting lines of argumentation in struggles for hegemony and legitimacy. Discussion and conclusions The paper demonstrates that a hybrid discursive regime relating to abortion characterizes the legally restrictive abortion context of Tanzania. We argue that such a complex discursive landscape, which cuts across the restrictive - liberal divide, generates an environment that seems to open avenues for enhanced access to abortion related knowledge and services.

Reproductive health and the politics of abortion

“…The various actors' positions on the abortion law are shaped in policy environments increasingly influenced by global actors and international networks in a dynamic interplay with local norms and values. Sambaiga and colleagues' case study from Tanzania Health, Life and Rights: A Discourse Analysis of a Hybrid Abortion Regime in Tanzania [12] explores the multiplicity of discourses surrounding the abortion issue within the context of a highly restrictive abortion law. The paper problematizes the common notion of the Tanzanian abortion landscape as unambiguously conservative / restrictive.…”

The Relationship Between Access to Abortion and Mental Health in Women of Childbearing Age: Analyses of Data From the Global Burden of Disease Studies

“…Second, the estimated values for the prevalence of mental disorders in each country are based on a combination of data from the available literature and estimates based on statistical models; there may be a certain margin of error in these estimates, particularly in low- and middle-income countries [ 65 ]. Third, information on abortion policies provides only a partial picture of access to abortion - certain countries may have relatively “liberal” policies in theory, but women in these countries may encounter practical “informal” barriers to accessing abortion services [ 63 , 66 ]. Fourth, the findings of this study apply only at a broader population level and cannot be applied directly to individuals; it is not possible to conclude, based on these results, whether refusal of abortion would necessarily lead to depression or anxiety in a particular woman.…”

Disparities in Accessing Sexual and Reproductive Health Services at the Intersection of Disability and Female Adolescence in Tanzania

“…Despite policy-level commitment to adolescent-friendly SRH services [ 26 , 62 ], the facilities that actually implement it are few [ 29 ]. The problematic implementation of adolescent SRH policies may result from the complex discursive SRHR landscape that spreads across the restrictive–liberal divide in Tanzania [ 63 ]. According to Bylund et al [ 28 ], complexity in adolescent SRHR may be intensified by contradictory and inconsistent messages regarding SRHR policies, the legal framework for providing services to underaged adolescents; the president’s personal views on SRHR; and community attitudes.…”