Comparison of Abortion Laws in Malawi and Zambia

Critical conjunctions:
Abortion laws and policies in
Malawi and Zambia
Dr Ernestina Coast
Dr Emily Freeman
London School of Economics
Abortion Research to Policy.
Addis Ababa 30
th
 November 2016
Why compare countries?
Contrasts
Similarities
Commonalities
Patterns
Stakeholders
Arguments
Evidence
Motivations
Processes
Outcomes
}
Current legal positions
Malawi
Abortions can be legally
performed to save the life
of the pregnant woman.
Zambia
Continuing a pregnancy involves a risk to
the life of the pregnant woman, her
physical or mental health or that of any
of her existing children, greater than if
the pregnancy were terminated; or a
child born of the pregnancy would suffer
from such physical or mental
abnormalities as to be seriously
handicapped.
Medical practitioners may take account
of the pregnant woman’s actual or
foreseeable environment and her age
Explicitly includes rape or defilement of a
female child as legal reason for inducing
abortion and to exempt from prosecution
female children who have attempted to
self-abort in these circumstances
Contexts today
Malawi
Draft Termination of
Pregnancy Bill
Not yet before Parliament
Liberalisation of grounds on
which abortion may be
performed legally to include
Danger to life
Physical + mental health
Malformation of the foetus
Rape
Defilement
Incest
Zambia
2016 Referendum on
changes to the Bill of Rights
in the Constitution
Para 15(2) “The life of a
person begins at
conception”
Threshold of 50% of eligible
voters not met (44%
achieved)
Unclear next steps
Contexts today
Malawi
Draft Termination of
Pregnancy Bill
Not yet before Parliament
Liberalisation of grounds on
which abortion may be
performed legally to include
Danger to life
Physical + mental health
Malformation of the foetus
Rape
Defilement
Incest
Zambia
2016 Referendum on
changes to the Bill of Rights
in the Constitution
Para 15(2) “The life of a
person begins at
conception”
Threshold of 50% of eligible
voters not met (44%
achieved)
Unclear next steps
Malawi
Highly restricted legal
grounds
Liberalisation?
Zambia
Broad range of legal
grounds
Restriction?
Sources of evidence
Primary 
 
Media reports (print and social)
Key informant interviews
Documents (including drafts)
Secondary
Research and evidence
A PARTIAL HISTORY
 
TOP Act
TOP Act
amended
Ratified Maputo
Protocol
Ipas starts
working
Strategic
assessment
unsafe
abortion
Post Abortion
Task Force
established
Standards &
Guidelines
ToP Act
amended
Planned Parenthood
Association of
Zambia established
Ipas
establishes full
country
programme
International treaties
National instruments
Ministries
NGOs
Marie Stopes
Zambia: abortion
services
1
9
7
2
2016
2000
 1994
2005
2006
2008
2009
2011
2012
1st Draft of
Constitution
“life begins
at
conception”
Referendum:
inquorate
Ratified Maputo
Protocol
1
9
3
0
Penal Code
Communique
signed by leaders of
11 political parties
supporting law
reform on abortion
Ipas starts
working
COPUA
established
1987 BLM started
Strategic assessment unsafe
abortion
 1987
Draft
Bill
2015
2007 PAC Strategy
Evidence
2007
2013
Law Commission
review published
Health systems
costs
Abortion incidence
2010
Standards &
Guidelines
LEGAL LANDSCAPE
 
TOP Act
TOP Act
amended
Ratified Maputo
Protocol
Ipas starts
working
Strategic
assessment
unsafe
abortion
Post Abortion
Task Force
established
Standards &
Guidelines
ToP Act
amended
Planned Parenthood
Association of
Zambia established
Ipas
establishes full
country
programme
International treaties
National instruments
Ministries
NGOs
Marie Stopes
Zambia: abortion
services
1
9
7
2
2016
2000
 1994
2005
2006
2008
2009
2011
2012
1st Draft of
Constitution
“life begins
at
conception”
Referendum:
inquorate
Ratified Maputo
Protocol
1
9
3
0
Penal Code
Communique
signed by leaders of
11 political parties
supporting law
reform on abortion
Ipas starts
working
COPUA
established
1987 BLM started
Strategic assessment unsafe
abortion
 1987
Draft
Bill
2015
2007 PAC Strategy
Evidence
2007
2013
Law Commission
review published
Health systems
costs
Abortion incidence
2010
Standards &
Guidelines
NGO PRESENCE/ACTIVITY
 
TOP Act
TOP Act
amended
Ratified Maputo
Protocol
Ipas starts
working
Strategic
assessment
unsafe
abortion
Post Abortion
Task Force
established
Standards &
Guidelines
ToP Act
amended
Planned Parenthood
Association of
Zambia established
Ipas
establishes full
country
programme
International treaties
National instruments
Ministries
NGOs
Marie Stopes
Zambia: abortion
services
1
9
7
2
2016
2000
 1994
2005
2006
2008
2009
2011
2012
1st Draft of
Constitution
“life begins
at
conception”
Referendum:
inquorate
Ratified Maputo
Protocol
1
9
3
0
Penal Code
Communique
signed by leaders of
11 political parties
supporting law
reform on abortion
Ipas starts
working
COPUA
established
1987 BLM started
Strategic assessment unsafe
abortion
 1987
Draft
Bill
2015
2007 PAC Strategy
Evidence
2007
2013
Law Commission
review published
Health systems
costs
Abortion incidence
2010
Standards &
Guidelines
EVIDENCE PRODUCTION +
CONSUMPTION
“National policy change usually begins with
documentable evidence of the problem and clear
articulation of solutions.” IPAS, 2016
Good reproductive health policy starts with credible
research (Guttmacher)
Generating evidence for policy and practice (APHRC)
TOP Act
TOP Act
amended
Ratified Maputo
Protocol
Ipas starts
working
Strategic
assessment
unsafe
abortion
Post Abortion
Task Force
established
Standards &
Guidelines
ToP Act
amended
Planned Parenthood
Association of
Zambia established
Ipas
establishes full
country
programme
International treaties
National instruments
Ministries
NGOs
Marie Stopes
Zambia: abortion
services
1
9
7
2
2016
2000
 1994
2005
2006
2008
2009
2011
2012
1st Draft of
Constitution
“life begins
at
conception”
Referendum:
inquorate
Ratified Maputo
Protocol
1
9
3
0
Penal Code
Ipas starts
working
COPUA
established
1987 BLM started
Strategic assessment unsafe
abortion
 1987
Draft
Bill
2015
2007 PAC Strategy
Evidence
2007
2013
Law Commission
review published
Health systems
costs
Abortion incidence
2010
Regulatory
Impact
Assessment
Malawi
Maputo Protocol a “trigger”
Abortion “did not fit with MDGs because no
evidence”
Series of studies
Strategic Assessment (2011)
Incidence of Induced Abortion (2013)
Health systems costs (2015)
Tonight, we’re going to let the statistics
speak for themselves”
Letting the evidence speak for itself?
Evidence/statistics a critical entry point
“Getting the conversation going”
Evidence/statistics necessary but insufficient
Role of “champions”
“Don’t expect me to go to my constituents – they’ll
kick me out” [MP]
Private agreement but public distancing
Coalitions
Zambia:
Standards & Guidelines do the talking
CROSS-NATIONAL “LEARNING” (?)
 
On the one hand:
Malawi Law Commission on abortion visited
Ethiopia
Zambia
Mauritius
On the other:
“Stop cheating people that liberalized abortion was
justifiable because of rising cases of maternal
mortality rate….We have an example of Zambia and
other countries, where abortion was liberalized, yet
maternal death is still on the higher side”
Ethics, Peace and Justice Commission
(Evangelical Association of Malawi)
On the one hand:  Malawi Law Commission on
abortion visited
Ethiopia
Zambia
Mauritius
On the other hand:
“Stop cheating people that liberalized abortion was
justifiable because of rising cases of maternal
mortality rate….We have an example of Zambia and
other countries, where abortion was liberalized, yet
maternal death is still on the higher side”
Ethics, Peace and Justice Commission
(Evangelical Association of Malawi)
Religious/faith-based groups
Malawi
USA-based evangelic
Christian groups lobbying
MPs (2016)
Concerns about abortion
and gay rights articulated
simultaneously
Episcopal Conference of
Malawi (ECM)
Zambia
Zambia officially a Christian
country
South African-based
“Doctors for Life”
An aside about presenting
evidence:
Women who have had
abortions assumed to have no
faith
Pastoral Statement (2016)
“We, the Bishops of the Catholic Church in Malawi
are aware of the pressure that the Government has
endured so far from foreign nations and agencies
who attach their financial support to values and
practices that are contrary to our culture. We
applaud the efforts and the courage the
Government has demonstrated so far to resist the
pressure to adopt such foreign values and practices
i.e. homosexuality and abortion. We wish to
reaffirm that such practices are not only against our
cultural values but are also contrary to our laws and
beliefs.”
Religious/faith-based groups
Malawi
USA-based evangelic
Christian groups lobbying
MPs (2016)
Concerns about abortion
and gay rights articulated
simultaneously
Episcopal Conference of
Malawi (ECM)
Zambia
Zambia officially a Christian
country
South African-based
“Doctors for Life”
An aside about presenting
evidence:
Women who have had
abortions assumed to have no
faith
LAW NECESSARY BUT INSUFFICIENT
 
Zambia
Services not widely available
Urban focus (public and private)
Low levels of knowledge about the law
Public
Medical professionals
Services inaccessible
3 signatures
Regulatory Impact Assessment
No broad-based coalition (yet)
Opportunity for learning from Malawi?
Malawi
Highly restricted legal
grounds
Liberalisation?
No change?
Zambia
Broad range of legal
grounds
Restriction?
Increased access?
THANK YOU
e.coast@lse.ac.uk
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Dr. Ernestina Coast and Dr. Emily Freeman from the London School of Economics conducted research on the critical conjunctions of abortion laws and policies in Malawi and Zambia. The current legal positions in both countries differ, with Malawi allowing a broader range of legal grounds for abortion compared to Zambia, which has highly restricted grounds. The context today includes discussions on a draft Termination of Pregnancy Bill in both countries, with potential liberalization of grounds for legal abortion under consideration.


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  1. Critical conjunctions: Abortion laws and policies in Malawi and Zambia Dr Ernestina Coast Dr Emily Freeman London School of Economics Abortion Research to Policy. Addis Ababa 30thNovember 2016

  2. Why compare countries? Stakeholders Arguments Evidence Motivations Processes Outcomes Contrasts Similarities Commonalities Patterns

  3. Current legal positions Malawi Zambia Continuing a pregnancy involves a risk to the life of the pregnant woman, her physical or mental health or that of any of her existing children, greater than if the pregnancy were terminated; or a child born of the pregnancy would suffer from such physical or mental abnormalities as to be seriously handicapped. Medical practitioners may take account of the pregnant woman s actual or foreseeable environment and her age Explicitly includes rape or defilement of a female child as legal reason for inducing abortion and to exempt from prosecution female children who have attempted to self-abort in these circumstances Abortions can be legally performed to save the life of the pregnant woman.

  4. Contexts today Malawi Zambia Draft Termination of Pregnancy Bill Not yet before Parliament Liberalisation of grounds on which abortion may be performed legally to include Danger to life Physical + mental health Malformation of the foetus Rape Defilement Incest 2016 Referendum on changes to the Bill of Rights in the Constitution Para 15(2) The life of a person begins at conception Threshold of 50% of eligible voters not met (44% achieved) Unclear next steps

  5. Contexts today Malawi Zambia Draft Termination of Pregnancy Bill Not yet before Parliament Liberalisation of grounds on which abortion may be performed legally to include Danger to life Physical + mental health Malformation of the foetus Rape Defilement Incest 2016 Referendum on changes to the Bill of Rights in the Constitution Para 15(2) The life of a person begins at conception Threshold of 50% of eligible voters not met (44% achieved) Unclear next steps

  6. Zambia Malawi Broad range of legal grounds Highly restricted legal grounds Restriction? Liberalisation?

  7. Sources of evidence Primary Media reports (print and social) Key informant interviews Documents (including drafts) Secondary Research and evidence

  8. A PARTIAL HISTORY

  9. Planned Parenthood Association of Zambia established Ipas starts working Ipas establishes full country programme Post Abortion Task Force established Marie Stopes Zambia: abortion services Standards & Guidelines Ratified Maputo Protocol Standards & Guidelines TOP Act 1st Draft of Constitution life begins at conception Referendum: inquorate ToP Act amended TOP Act amended Strategic assessment unsafe abortion 1972 2005 2013 1930 2015 2016 2000 1994 2007 2011 1987 2009 2010 2012 2006 2008 Draft Bill Ipas starts working Abortion incidence Ratified Maputo Protocol Law Commission review published 1987 BLM started 2007 PAC Strategy Health systems costs COPUA established Communique signed by leaders of 11 political parties supporting law reform on abortion Penal Code Strategic assessment unsafe abortion Evidence Ministries NGOs National instruments International treaties

  10. LEGAL LANDSCAPE

  11. Planned Parenthood Association of Zambia established Ipas starts working Ipas establishes full country programme Post Abortion Task Force established Marie Stopes Zambia: abortion services Standards & Guidelines Ratified Maputo Protocol Standards & Guidelines TOP Act 1st Draft of Constitution life begins at conception Referendum: inquorate ToP Act amended TOP Act amended Strategic assessment unsafe abortion 1972 2005 2013 1930 2015 2016 2000 1994 2007 2011 1987 2009 2010 2012 2006 2008 Draft Bill Ipas starts working Abortion incidence Ratified Maputo Protocol Law Commission review published 1987 BLM started 2007 PAC Strategy Health systems costs COPUA established Communique signed by leaders of 11 political parties supporting law reform on abortion Penal Code Strategic assessment unsafe abortion Evidence Ministries NGOs National instruments International treaties

  12. NGO PRESENCE/ACTIVITY

  13. Planned Parenthood Association of Zambia established Ipas starts working Ipas establishes full country programme Post Abortion Task Force established Marie Stopes Zambia: abortion services Standards & Guidelines Ratified Maputo Protocol Standards & Guidelines TOP Act 1st Draft of Constitution life begins at conception Referendum: inquorate ToP Act amended TOP Act amended Strategic assessment unsafe abortion 1972 2005 2013 1930 2015 2016 2000 1994 2007 2011 1987 2009 2010 2012 2006 2008 Draft Bill Ipas starts working Abortion incidence Ratified Maputo Protocol Law Commission review published 1987 BLM started 2007 PAC Strategy Health systems costs COPUA established Communique signed by leaders of 11 political parties supporting law reform on abortion Penal Code Strategic assessment unsafe abortion Evidence Ministries NGOs National instruments International treaties

  14. National policy change usually begins with documentable evidence of the problem and clear articulation of solutions. IPAS, 2016 Good reproductive health policy starts with credible research (Guttmacher) Generating evidence for policy and practice (APHRC) EVIDENCE PRODUCTION + CONSUMPTION

  15. Planned Parenthood Association of Zambia established Ipas starts working Ipas establishes full country programme Post Abortion Task Force established Marie Stopes Zambia: abortion services Regulatory Impact Assessment Ratified Maputo Protocol Standards & Guidelines TOP Act 1st Draft of Constitution life begins at conception Referendum: inquorate ToP Act amended TOP Act amended Strategic assessment unsafe abortion 1972 2005 2013 1930 2015 2016 2000 1994 2007 2011 1987 2009 2010 2012 2006 2008 Draft Bill Ipas starts working Abortion incidence Ratified Maputo Protocol Law Commission review published 1987 BLM started 2007 PAC Strategy COPUA established Penal Code Strategic assessment unsafe abortion Health systems costs Evidence Ministries NGOs National instruments International treaties

  16. Malawi Maputo Protocol a trigger Abortion did not fit with MDGs because no evidence Series of studies Strategic Assessment (2011) Incidence of Induced Abortion (2013) Health systems costs (2015)

  17. Tonight, were going to let the statistics speak for themselves

  18. Letting the evidence speak for itself? Evidence/statistics a critical entry point Getting the conversation going Evidence/statistics necessary but insufficient Role of champions Don t expect me to go to my constituents they ll kick me out [MP] Private agreement but public distancing Coalitions

  19. Zambia: Standards & Guidelines do the talking

  20. CROSS-NATIONAL LEARNING (?)

  21. On the one hand: Malawi Law Commission on abortion visited Ethiopia Zambia Mauritius On the other: Stop cheating people that liberalized abortion was justifiable because of rising cases of maternal mortality rate .We have an example of Zambia and other countries, where abortion was liberalized, yet maternal death is still on the higher side Ethics, Peace and Justice Commission (Evangelical Association of Malawi)

  22. On the one hand: Malawi Law Commission on abortion visited Ethiopia Zambia Mauritius On the other hand: Stop cheating people that liberalized abortion was justifiable because of rising cases of maternal mortality rate .We have an example of Zambia and other countries, where abortion was liberalized, yet maternal death is still on the higher side Ethics, Peace and Justice Commission (Evangelical Association of Malawi)

  23. Religious/faith-based groups Malawi USA-based evangelic Christian groups lobbying MPs (2016) Concerns about abortion and gay rights articulated simultaneously Episcopal Conference of Malawi (ECM) Zambia Zambia officially a Christian country South African-based Doctors for Life An aside about presenting evidence: Women who have had abortions assumed to have no faith

  24. Pastoral Statement (2016) We, the Bishops of the Catholic Church in Malawi are aware of the pressure that the Government has endured so far from foreign nations and agencies who attach their financial support to values and practices that are contrary to our culture. We applaud the efforts and the courage the Government has demonstrated so far to resist the pressure to adopt such foreign values and practices i.e. homosexuality and abortion. We wish to reaffirm that such practices are not only against our cultural values but are also contrary to our laws and beliefs.

  25. Religious/faith-based groups Malawi USA-based evangelic Christian groups lobbying MPs (2016) Concerns about abortion and gay rights articulated simultaneously Episcopal Conference of Malawi (ECM) Zambia Zambia officially a Christian country South African-based Doctors for Life An aside about presenting evidence: Women who have had abortions assumed to have no faith

  26. Malawi Zambia Coalitions COPUA multi-interest Medical: Little evidence of activity ( beyond individual champions ) Legal: Highly active Adolescents as stakeholders Abortion as an adolescent issue No broad coalition Medical: Active participation and debate Abortion as an adolescent issue Adolescents Social construction of abortion discourses not Malawian not Zambian Ministry sites Reproductive Health Unit (MoH) - MoH - Technical Working Groups

  27. LAW NECESSARY BUT INSUFFICIENT

  28. Zambia Services not widely available Urban focus (public and private) Low levels of knowledge about the law Public Medical professionals Services inaccessible 3 signatures Regulatory Impact Assessment No broad-based coalition (yet) Opportunity for learning from Malawi?

  29. Zambia Malawi Broad range of legal grounds Highly restricted legal grounds Restriction? Increased access? Liberalisation? No change?

  30. THANK YOU e.coast@lse.ac.uk

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