SUMARGA

The Power of Informed Reproductive Decisions

Nepal made a historical achievement in reproductive health and rights for women in September 2002 when abortion was legalized. The legislative change facilitates the government and civil societies to initiate programs and policies aimed at reducing abortion related maternal mortality and morbidity in the country.

One of the main post-legalization challenges for Nepal is “ how to make legal and safe abortion services accessible to all women without fear of stigmatization and as women’s reproductive rights”. Public Opinion Poll conducted by CREHPA in October 2002 revealed that just 22 percent of the urban adult population was aware that abortion has been legalized in Nepal.

Legal reform alone cannot reduce abortion related deaths in our country. Public education and advocacy campaigns are crucial to create awareness about the new legislation, modify society’s attitude towards abortion, prevent unsafe and illegal practices, inform about legal and safe abortion care services and create enabling environment for women and couples to make informed decisions on their unintended pregnancies.

“sumarga” (meaning right or correct path) is a new education, communication and advocacy program of CREHPA and its partner NGOs launched in July 2003 to address the post-legalization challenges and choices. This new initiative builds upon the Public Education and Advocacy Program (PEAP) against unsafe abortion initiated by CREHPA in 1999 in response to the policy issues raised in a series of research studies on abortion in Nepal and the need for legal reform as a precondition to save women’s lives.

“sumarga” signifies a woman’s access to knowledge and information about reproductive health and rights and protection of these rights;

“sumarga” symbolizes women’s awareness on and empowerment for making informed decisions on their fertility including legal and safe termination of unintended pregnancies;

“sumarga” bridges the knowledge & information gaps on abortion law and enhances awareness among the stakeholders, community members, women, youths and adolescents about the potential risk of unsafe abortions;

“sumarga” compliments the Safe Abortion Policy of the Government (Ministry of Health), facilitates research and translates policies and strategies into action.

Vision

A society where women and couples exercise their reproductive rights, make informed reproductive decisions and enjoy healthy life with dignity

Mission

Contribute towards improving maternal health by creating positive environment to enable women & couples for making informed decisions on their pregnancies, including termination of unintended pregnancies through alliances, partnerships, mobilization, education, research and advocacy initiatives.

“sumarga” Objectives

• Contribute to creating enabling environment for women and couples to make informed decisions on their fertility including unintended pregnancies;
• To increase communities’ access to information on the abortion law and the availability of quality, affordable and legal comprehensive abortion care services;
• To create positive socio-cultural environment for every women to choose available pregnancy termination procedures approved by the government and as appropriate to her condition, without fear of stigmatization;
• To conduct abortion related research and recommend for improvement of program management practices in the country.

Proposed Activities under “sumarga”

• Interactive meetings and workshops at national and regional levels to discuss the abortion policy, comprehensive abortion care strategies and program issues;
• Sensitization of outreach health care providers/community health volunteers on the abortion law, women’s reproductive rights, legal and safe abortion procedures, client counseling and referral to a recognized CAC service provider/institution;
• Sensitization meetings, advocacy workshops for local authorities and other key stakeholders at the districts and village development committees in partnership with local NGOs;
• Training (Masters’ Training and Training of Trainers) and group interaction workshops for partner NGOs and leaders of their community-based organizations (CBOs) such as mothers’ groups, women’s saving & credit groups, forestry & other consumers’ groups, etc;
• Designing appropriate IEC materials to reach target population (young married couples, Pregnant women, antenatal visitors, mother of < 5 children);
• Use of cost effective media channels such as radio, TV and newspapers for dissemination of information and advocacy;
• Promotion of talk programs and debate competitions on abortion related issues in secondary schools and colleges;
• Coordination with district authorities, medical and educational institutions for expansion of IEC and advocacy activities;
• Establishment of “sumarga” Information Center (SIC) at community level in pilot districts to be managed by local CBOs;
• Periodic research including operations research and opinion polls on policy relevant abortion issues and organizing seminars and press conferences for dissemination of research results.

Current Program

CREHPA has launched “sumarga” program in 20 districts since July 2003 in partnership with district based NGOs. Majority of these districts are in the western, mid western and far western regions of Nepal. Only selected activities are marked for implementation for the July 2003 – April 2004 period. These activities are:

• Sensitization workshops for new Partner NGOs
• District level advocacy workshops for stakeholders
• Radio/FM program
• Masters’ Training and Training of Trainers for Partner NGOs
• Regional level Review Meetings
• Development of IEC materials
• Update of data on abortion
• Public Opinion Poll & Press Conference
• Capacity building of Team members

Collaboration/Alliance

Major part of the “sumarga” activities is in line with the National Safe Abortion Policy Strategies 2002 of the Ministry of Health (MOH). CREHPA has been the member of the Abortion Task Force (which was dissolved in December 2002 after successful accomplishment of its task) and member of the Technical Committee for Implementation of Comprehensive Abortion Care (TCIC) formed by the Ministry of Health.

CREHPA works in collaboration with Planned Parenthood Federation of America International (PPFA-I); Ipas; and the Population Council Bangladesh (on Emergency Contraception). At the national level, it collaborates with Family Planning Association of Nepal and Nepal Safe Motherhood Network.

During the past 4-5 years, the Ford Foundation has been the sole grantee for CREHPA for its public education and advocacy initiatives (May 1999 to April 2003). Ford has extended the grants for another three years (2003 - 2006). PPFA-I (community education and advocacy) and Ipas (medical abortion study) are two other grantees in the current year 2003.

Resource Needs

Expansion of “sumarga” is necessary to fulfill the program objectives and meet the post-legalization challenges and choices. Resource needs are enormous. Available funds can meet the partial needs of “sumarga” activities. CREHPA welcomes technical collaboration and financial assistance from rights based organizations and donors in the following areas:

• Media/BCC campaigns;
• Establishment of a central resource center and “sumarga” information centers at community levels ;
• Expansion of training activities in phased manner to cover outreach health providers/volunteers;
• IEC materials reprints;
• Situational assessment studies;
• Special programs for educational institutions & NGOs.