The Chronicle (Lilongwe)

17 October 2006

Africa: AU Countries Fail to Agree On Abortion

Lilongwe — African Union (AU) Health Ministers adopted a Continental Policy Framework for Sexual and Reproductive Health and Rights last week in Maputo Mozambique, but failed to agree on how to tackle the issue of unsafe abortions as a united force and opted to take it up separately.

Dr Thomas Bisika, Head of Division, Health, HIV/AIDS, Nutrition, Other Related Infection Diseases and Population in the Department of Social Affairs said in an interview that since the ministers have adopted the plan to operationalise the Continental Policy Framework and it is now one of the AU's instruments.

However, countries differed on the modalities on how to tackle the issue of unsafe abortions as member countries argued and counter argued on whether or not the issue of abortion could be taken up as a family planning matter.

Bisika however, insisted that despite the contention over the issue from some member countries they all agreed that unsafe abortions are responsible for most maternal deaths in Africa, especially among young girls.

The conference delegates stressed that they really want to address the problem but differed on how to approach it. They eventually agreed to tackle it differently, based on the social environment prevailing in their respective countries.

"People realised that abortion is not really a family planning method. The agreement is that people have to embark on programmes that enhance the avoidance of unsafe abortions," said Bisika in an interview with The Chronicle.

"But what we are saying is that abortion services should be provided to the full extent of the law, especially in cases like where the mother is at risk with the baby and in issues of incest," he said.

Bisika said the first part of the adoption process was the comprehensive scrutiny which the health ministers gave the Draft Action Plan which was critiqued and fine-tuned by experts from member countries, donors and other stakeholders three days before the ministers' meeting.

The health ministers at the session felt that the document had more or less addressed what they were expecting to see in the plan of action.

However, AU could not be explicit on whether or not there are any penalties that could be imposed on member countries that fail to achieve what is outlined in the Plan of Action.

Bisika insisted that in this respect the Commission clarified from the onset that this Plan of Action is not like a charter or some other treaty to which member states are tied to.

"Rather, it is just a framework from which the countries are supposed to draw inspiration and improve their own countries' plans because we are aware that most countries already have frameworks," he says.

He said the Plan of Action has basic strategic indicators, or progress and impact indicators which will show which country is behind; which country is doing well and which is not doing so well.

Mozambique's National Health Director Mouzinho Saide said different countries have different positions on plans and policies which are not like what has been adopted.

"We have HIV problems, we have reproductive health problems, we have child problems; all these were put into plans of their interventions which were not integrated. Now what this Plan of Action has done is to integrate all these into one big plan and this is the best way to improve health and achieve MDGs," he said.

"This is a very important step in Africa. We have never sat down together like this in the past to premeditate on a document that can guide us to have harmonised plans and strategies on health. This is the most important thing for Africa because now we can help each other to go in the same direction," she added.

Bisika acknowledged that although some countries have a framework of much higher quality than what the Plan of Action is espousing they should even get higher. However he said that if there are countries that have standards that are below what the action plan is asking then AU will encourage these countries to move and join the rest.

"The Plan of Action is for the 2007 to 2010 period and it is expected that there will be another Plan of Action that will cover the period of 2011 to 2015 so that the final evaluation will coincide with the overall evaluation exercise of the Millennium Development Goals," he said.

The draft version of the 'Maputo' Plan of Action says it seeks to take the continent forward towards the goal of universal access to comprehensive sexual and reproductive health services in Africa by 2015.

"It is a short term plan for the period up to 2010 built on eight action areas which include; the integration of sexual and reproductive health services into Primary Health Care (PHC), repositioning family planning, youth-friendly services, unsafe abortions, quality safe motherhood, resource mobilisation, commodity security and monitoring and evaluation," reads the draft in part.

The plan is also premised on Sexual and Reproductive Health (SRH) in its fullest context. This includes Adolescent Sexual and Reproductive Health (ASRH), Safe Motherhood; Abortion Care; Family Planning; Prevention and Management of Sexually Transmitted Infections including HIV and AIDS; Prevention and Management Infertility; Prevention and Management of Cancers of the Reproductive System; Mid-life concerns of both men and women; Women's Health Development including the Reduction of Gender-based Violence; Interpersonal Communication and Counselling; and Health education.

Bisika lauded the plan as a well conceived document which has been made in such a way that it has a provision of a cost estimate, unlike all other plans previously discussed.

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