Daire Judith, Kloster Maren O, Storeng Katerini T
Lecturer at the School of Public Health, Health Systems and Health Economics, Curtin University, Perth, West Australia, and was a lecturer at the College of Medicine, Faculty of Community Health, University of Malawi at the time of the study.
Candidate at the Centre for Development and the Environment, University of Oslo, Norway.
Health Hum Rights. 2018 Jun;20(1):225-236.
In July 2015, Malawi's Special Law Commission on the Review of the Law on Abortion released a draft Termination of Pregnancy bill. If approved by Parliament, it will liberalize Malawi's strict abortion law, expanding the grounds for safe abortion and representing an important step toward safer abortion in Malawi. Drawing on prospective policy analysis (2013-2017), we identify factors that helped generate political will to address unsafe abortion. Notably, we show that transnational influences and domestic advocacy converged to make unsafe abortion a political issue in Malawi and to make abortion law reform a possibility. Since the 1980s, international actors have promoted global norms and provided financial and technical resources to advance ideas about women's reproductive health and rights and to support research on unsafe abortion. Meanwhile, domestic coalitions of actors and policy champions have mobilized new national evidence on the magnitude, costs, and public health impacts of unsafe abortion, framing action on unsafe abortion as part of a broader imperative to address Malawi's high level of maternal mortality. Although these efforts have generated substantial support for abortion law reform, an ongoing backlash from the international anti-choice movement has gained momentum by appealing to religious and nationalist values. Passage of the bill also antagonizes the United States' development work in Malawi due to US policies prohibiting the funding of safe abortion. This threatens existing political will and renders the outcome of the legal review uncertain.
2015年7月,马拉维堕胎法审查特别法律委员会发布了一份《终止妊娠法案》草案。如果该草案获得议会批准,将放宽马拉维严格的堕胎法,扩大安全堕胎的理由,这是马拉维迈向更安全堕胎的重要一步。基于前瞻性政策分析(2013 - 2017年),我们确定了有助于产生解决不安全堕胎问题政治意愿的因素。值得注意的是,我们发现跨国影响和国内倡导相互交织,使不安全堕胎成为马拉维的一个政治问题,并使堕胎法改革成为可能。自20世纪80年代以来,国际行为体推动了全球规范,并提供资金和技术资源,以推进关于妇女生殖健康和权利的理念,并支持对不安全堕胎的研究。与此同时,国内的行动者联盟和政策倡导者收集了关于不安全堕胎的规模、成本和公共卫生影响的新的国家证据,将解决不安全堕胎问题的行动框定为应对马拉维高孕产妇死亡率这一更广泛紧迫任务的一部分。尽管这些努力为堕胎法改革赢得了大量支持,但国际反堕胎运动持续的强烈反对因诉诸宗教和民族主义价值观而势头渐长。该法案的通过也因美国禁止为安全堕胎提供资金的政策而使美国在马拉维的发展工作受到影响。这威胁到现有的政治意愿,并使法律审查的结果变得不确定。