At Ipas, we’re working with partners to build sustainable abortion ecosystems, recognizing that there are multiple factors that influence an individual’s ability to access abortion. In a sustainable abortion ecosystem, resilient local stakeholders and systems are actively accountable and committed to abortion rights and responsive to everyone’s abortion needs. In such an ecosystem, people have the information they need to make decisions about abortion and reproduction, there is community and political support for human rights and abortion access, and there are laws and policies that support comprehensive abortion care, sexual and reproductive health, and bodily autonomy.
There are eight components in our framework for a sustainable abortion ecosystem. We’ve also identified four essential drivers of the abortion ecosystem that are integral to achieving sustainability within every component: human rights and equity, partnerships and collaboration, local expertise, and ownership and accountability. Learn more about the eight components and four essential drivers below.
Mila wants an abortion. But can she access one?
The answer may depend on if Ipas and our partners have worked where Mila lives to ensure people have what they need every step of the way.
Abortion is legal
Comprehensive sexuality education is available
Communities have learned the importance of reproductive rights
Clinics and community groups offer sexual health information
Health providers have training in abortion care
Clinics have needed abortion care supplies
Abortion is free at public health clinics
Abortion is restricted
Comprehensive sexuality education is not available
Communities don’t know about reproductive rights
Clinics do not offer sexual health information
Health providers have not received abortion care training
Clinics don’t have abortion care supplies
Abortion is expensive
8 components of the abortion ecosystem
Individual knowledge and agency
Community social norms and support
Health information
Health workforce and service delivery
Commodities
Financing
Political support and leadership
Policy and legislation
Individual knowledge and agency
Working with one of Ipas Development Foundation’s partner organizations, youth leader Yashoda Pramanik has provided information on sexual and reproductive health and safe abortion care to rural young women—both married and unmarried—living in villages in Jharkhand.
“I enjoyed conducting small group interpersonal sessions with young women. Earlier I didn’t have correct knowledge of sexual and reproductive health and rights and comprehensive abortion care and used to face many problems due to lack of knowledge—and many other young women of my age faced similar situations. After joining [this project] as a youth leader, I not only learned about sexual and reproductive health and [safe abortion], but also helped other young women in my area.”
Community social norms and support
Krishna Pingua didn’t know much about sexual and reproductive health before joining the project. Now, he’s equipped with information—and he knows how important it is for men to be informed and supportive partners.
“I came to know that we should discuss what men should do in the society, how they should cooperate with women regarding everything—like when to have a child and when not to, and the use of contraceptives,” he says. He believes that men and women must have equal rights and that both male and female partners should be involved in family planning discussions.
Pingua feels that his work as a youth educator is meaningful. “When I talk to other men about sexual and reproductive health, I feel very proud that through sharing my knowledge, I am giving them the right guidance,” he says.
Health information
In Zambia’s capital, Lusaka, young people struggle to access sexual and reproductive health care—including abortion—due to stigma and lack of information, and a cultural belief that adults should not talk to young people about sex. “Youth-friendly corners” at local health centers have offered young people a private space to receive counseling and information from their peers. “Working with youth is important because they are future leaders,” says youth-friendly corner volunteer Nelly Nyendwa.
Young people seeking health-care services like contraception and safe abortion often face judgmental, disapproving attitudes from providers and health center staff—caused by stigma surrounding youth sexuality and abortion. Ipas’s youth partners identified the need for a separate, private registration area for young people at each health center offering youth-friendly services.
Whereas before youth faced scorn from adults at main registration desks, now they receive a warm greeting from caring volunteers their own age at youth-friendly corners
“Working with youth is important because they are future leaders,” says youth-friendly corner volunteer Nelly Nyendwa.
Health workforce and service delivery
Shamoly Khatun is a paramedic who works at 20 Beds Hospital on Bhasan Char island, where Bangladesh’s government has relocated tens of thousands of Rohingya refugees to alleviate crowding in the sprawling refugee camps on the mainland. Shamoly received training from Ipas and, since October 2021, she has been providing family planning, safe abortion care and treatment for complications of unsafe abortion (known as postabortion care).
“Mindsets have been changed among Rohingya women,” Shamoly says. “Now husbands are coming with their wives and seeking reproductive health care. This is a huge change. They also understand the importance of safe abortion and many of our patients are arriving without much delay.”
Commodities
Clement Kolove, Ipas Malawi country representative
“Our focus is on sexual and reproductive health in these camps because we know that women in the camps still need the services. And we also know the health system at the moment has been a bit disrupted.”
Financing
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Political support and leadership
Senator Maxima Apaza Millares, President of the Parliamentary Network for Children and Adolescents
An Aymara woman whose family came to La Paz from the high plateau region of western Bolivia, Senator Apaza Millares has worked with Ipas for years to educate people on the preventable public health problem of unsafe abortion, which disproportionately affects rural, indigenous women. “We cannot turn a blind eye to this reality,” she cautions.
With the reform of the penal code, for the first time women will be able to decide over their own bodies and that decision must be respected.”
Policy and legislation
Clement Kolove, Ipas Malawi country representative
“Our focus is on sexual and reproductive health in these camps because we know that women in the camps still need the services. And we also know the health system at the moment has been a bit disrupted.”
4 essential drivers of the abortion ecosystem
Human rights and equity
Partnerships and collaboration
Local expertise
Ownership and accountability
Human rights and equity
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Partnerships and collaboration
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Local expertise
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Ownership and accountability
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