Making Abortion Safer in Rwanda: Operationalization of the Penal Code of 2012 to
            Expand Legal Exemptions and Challenges

Hodoglugil, Nuriye Nalan Sahin; Ngabo, Fidèle; Ortega, Joanna; Nyirazinyoye, Laetitia; Ngoga, Eugene; Dushimeyezu, E.; Kanyamanza, E.; Prata, Ndola

doi:10.29063/ajrh2017/v21i1.7

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…Rwanda and Nigeria illustrate ways in which the combination regimen was added to the NEML despite more restrictive abortion laws. In Rwanda, the government took the pragmatic step to add mifepristone and misoprostol to the 2015 NEML to align with the revised penal code of 2012 which permitted abortion resulting from rape, incest, forced marriage, or on medical grounds [ 19 ]. Rwanda wanted to have all WHO recommended abortion methods [ 2 ] available in such cases and the NEML application was accepted.…”

Section: Resultsmentioning

confidence: 99%

Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities

et al. 2023

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Background In recent years a growing number of manufacturers and medical abortion products have entered country markets and health systems, with varying degrees of quality and accessibility. An interplay of factors including pharmaceutical regulations, abortion laws, government policies and service delivery guidelines and provider’s knowledge and practices influence the availability of medical abortion medicines. We assessed the availability of medical abortion in eight countries to increase understanding among policymakers of the need to improve availability and affordability of quality-assured medical abortion products at regional and national levels. Methods Using a national assessment protocol and an availability framework, we assessed the availability of medical abortion medicines in Bangladesh, Liberia, Malawi, Nepal, Nigeria, Rwanda, Sierra Leone and South Africa between September 2019 and January 2020. Results Registration of abortion medicines—misoprostol or a combination of mifepristone and misoprostol—was established in all countries assessed, except Rwanda. Mifepristone and misoprostol regimen for medical abortion was identified on the national essential medicines list/standard treatment guidelines for South Africa as well as in specific abortion care service and delivery guidelines for Bangladesh, Nepal, Nigeria, and Rwanda. In Liberia, Malawi, and Sierra Leone—countries with highly restrictive abortion laws and no abortion service delivery guidelines or training curricula—no government-supported training on medical abortion for public sector providers had occurred. Instead, training on medical abortion was either limited in scope to select private sector providers and pharmacists or prohibited. Community awareness activities on medical abortion have been limited in scope across the countries assessed and where abortion is broadly legal, most women do not know that it is an option. Conclusion Understanding the factors that influence the availability of medical abortion medicines is important to support policymakers improve availability of these medicines. The landscape assessments documented that medical abortion commodities can be uniquely impacted by the laws, policies, values, and degree of restrictions placed on service delivery programs. Results of the assessments can guide actions to improve access.

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Section: Resultsmentioning

confidence: 99%

Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities

et al. 2023

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“…Individual (Microsystem) and interpersonal (Mesosystem). Four articles discussed implications related to the role men play in maternal health [20,37,43,44,51]. These themes included the need to include men in discussions of FP and contraception and keeping them engaged in pregnancy discussions.…”

Section: Summary Of Included Study Implications Framed By the Ecologi...mentioning

confidence: 99%

“…Seven articles centered on the need for Rwanda's health system to support maternal health through providers ensuring that women feel respected, safe and able to advocate for themselves [29,30,34,50] and in terms of policies, to be sure there are ways for women to receive the health care they need [43,44,51]. Ndirima and colleagues [30] imply that women's expectations, suggestions, and needs can enhance providers' awareness of the women's priorities during childbirth and serve as a guidepost for health services to increase the quality, acceptability and uptake of maternal health services.…”

Section: Summary Of Included Study Implications Framed By the Ecologi...mentioning

confidence: 99%

Scoping review of qualitative studies investigating reproductive health knowledge, attitudes, and practices among men and women across Rwanda

et al. 2023

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Background Research efforts in Rwanda to improve sexual and reproductive health and rights (SRHR) are increasing; however, comprehensive literature reviews on SRHR are limited. This scoping review examines individual and contextual factors shaping knowledge, attitudes, and practices in the domains of: 1) family planning, 2) abortion care, and 3) other SRHR in Rwanda. Recognizing that individual, community, and societal factors influence RH, this review is guided by Bronfenbrenner’s Ecological Systems Theory. Methods Eligible studies were conducted in Rwanda, included males and/or females of any age, and were published within the past 20 years. Studies reporting views of only healthcare or other professionals were excluded. Results Thirty-six studies were included. The majority addressed individual and contextual considerations. At the individual level, studies explored knowledge about SRHR problems while at the interpersonal level, the support and attitudes of men and community members for adolescent SRHR were investigated. In terms of healthcare organization, maternal health practices, increased access to family planning programs, and the need for sexually transmitted infection programs was explored. At the social and cultural level, researchers investigated beliefs and traditional gender roles. Regarding public health policy, studies mentioned promoting and increasing funding for SRHR and reducing gender inequities. Conclusion Our findings can inform SRHR research programs, public health campaigns, and policy advances in Rwanda.

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“…6 Some studies employed in-depth interviews to identify successes and problems in specific country contexts. 4,7 However, these studies were not designed to inform the development of a practicebased guide for the implementation of health services. One multicountry report did offer a framework for the successful implementation of abortion services; it relied primarily on a review of published and "grey" literature although it included some interviews with key informants.…”

Section: Andmentioning

confidence: 99%

“…Some articles have described the context and the actors involved in abortion reform in specific countries, including Uruguay, Colombia, and Nepal . Some studies employed in‐depth interviews to identify successes and problems in specific country contexts . However, these studies were not designed to inform the development of a practice‐based guide for the implementation of health services.…”

Section: Introductionmentioning

confidence: 99%

Implementing and expanding safe abortion care: An international comparative case study of six countries

Chavkin

Stifani

Bridgman-Packer

et al. 2018

Intl J Gynecology & Obste

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We conducted a comparative case study‐based investigation of health sector strategies that were useful in expanding or establishing new abortion services. We selected geographically diverse countries from across the human development index if they had implemented new abortion laws, or changed interpretations of existing laws or policies, within the past 15 years (Colombia, Ethiopia, Ghana, Portugal, South Africa, and Uruguay). Factors facilitating the expansion of services include use of a public health frame, situating abortion as one component of a comprehensive reproductive health package, and including country‐based health and women's rights organizations, medical and other professional societies, and international agencies and nongovernment organizations in the design and rollout of services. Task sharing and the use of techniques that do not require much infrastructure, such as manual vacuum aspiration and medical abortion, are important for rapid establishment of services, especially in low‐resource settings. Political will emerged as the key factor in establishing or expanding access to safe abortion services.

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Making Abortion Safer in Rwanda: Operationalization of the Penal Code of 2012 to Expand Legal Exemptions and Challenges

Cited by 7 publications

References 7 publications

Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities

Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities

Scoping review of qualitative studies investigating reproductive health knowledge, attitudes, and practices among men and women across Rwanda

Implementing and expanding safe abortion care: An international comparative case study of six countries

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