Situation Analysis:

• Even after 33 years of the Medical Termination of Pregnancy Act (MTP Act) which legalized abortion and has been further amended in 2003 to facilitate its better implementation, the number of certified, safe and legal abortion facilities hardly account for 24% of the private centers.
• Providers lack capacity to follow new techniques and provide quality of care in safe abortion.
• For every one abortion there are 10 abortions performed outside the health system. The number of illegally induced abortion is in the range of 4 to 6 million per year.
• There are about 12% maternal death among adult women and 50% among 15 to 19 years old girls due to unsafe abortion
• The high unmet need for FP (16%) lead to repeat and unsafe abortion.
• Overwhelming reason for seeking abortion among married women is to limit the family size.
• Hardly 15% of women opt for abortion for reasons related to contraceptive failure or biological reasons.
• The sex selective abortion is substantially contributing towards a fall in child sex ratio (0-6 years' age group).
• Beside lack of knowledge about abortion being legal, there are also strong cultural barriers and providers bias which prevent women to access safe.

Strategic Direction: By lobbying and advocating for a woman’s right to safe abortion, forging partnership with government and upgrading facilities in the SDPs run by the MA for preventing unsafe as well as sex selective abortion.

Goal: A universal recognition of a woman’s right to choose and have access to safe abortion, and a reduction in the incidence of unsafe abortion.

Objective1:  To increase access to safe abortion to 35% of marginalized and underserved women.

Activities:

• Conduct needs assessment of 30 SDPs extending safe abortion services and analyse barriers to safe abortion.
• Upscale facilities at SDPs and widen the range of safe abortion procedures, provide quality services for safe abortion at 30 SDPs with a backup of counseling for prevention of unwanted pregnancy and pre and post abortion care.
• Hold seminars and workshops for volunteers-staff, clients and other stakeholders on the efficacy of MVA & medical procedures of safe abortion.
• Organise capacity building programmes for service providers including training of trainers in surgical as well as MVA and medical procedures of safe abortion.
• Document and share experience with members of Medical Advisory Panel (MAP) and other advisory committees at Branch/regional levels, policy makers/executives and utilize their expertise for quality improvement.
• Develop monitoring and evaluation tools and documentation package.

Objective 2: To raise awareness among the general public, policy makers and key professional groups on the public health and social justice impact of unsafe abortion.

Activities:

• Collect, analyze and disseminate abortion related data including knowledge and attitude of people, policy makers/executives regarding right to choose and have access to safe abortion with linkages to human rights and legal status of abortion.
• Hold capacity building programmes for service providers for advocacy of reproductive rights and legal issues related to safe abortion.
• Hold seminars, workshops round table meets for clients and the members of their community/family networks and other key stakeholders including human rights and religious groups on women’s rights and safe abortion and implications of unsafe and sex selective abortion.
• Help partner organizations/service providers for creation of facilities for legal and safe abortion.
• Cooperate and collaborate with government for effective enforcement of PNDT Act and discourage the practice of sex selective abortion.
• Conduct evidence based studies on the incidence and impact of unsafe abortion on the health and well being of women, their families and marginalized groups.

Outcomes and Indicators: