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Restrictive laws threaten women’s health rights

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FOR MINDSET CHANGE— Kalimbe

Chrissy Chamveka, who is Machinga District Family Planning Coordinator, is a happy woman these days.

“This is because the intake of family planning methods has increased these days,” she said during a meeting the Centre for Solutions Journalism organised for journalists at Liwonde in Machinga District.

“At first, people did not take family planning issues seriously. For instance, a man from Machinga would marry here, bear children with his wife, trek to South Africa, marry, and have more children. Back home [in Machinga, Malawi], women who felt that their husbands had spent a long time in South Africa would remarry, have more children and pile pressure on natural resources in the district,” she added.

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Chamveka attributes the success of family planning methods intake among couples in the district to changes to laws related to sexual and reproductive health rights.

“At first, unmarried women were not being given a chance to use contraceptive methods. Again, married women were not allowed to seek services related to family planning methods without the consent of their husbands, which was hampering access to the same. The case is different now and the benefits are there for all to see,” she said.

In Malawi, according to a Media Aids and Health Watch Policy Brief, family planning started in the 1960s, was banned in the 1970s, only to be re-introduced in 1982 after Ministry of Health officials observed that the population was spiralling out of control.

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According to Chamveka, however, the district continues to face some challenges, including those related to access to termination of pregnancy services.

This could be because, although Malawi has a proposed Termination of Pregnancy Bill, Parliament is yet to deliberate on the same.

According to lawyer Mateyu Sisya, the Penal Code section [243] which addresses the issue of access to abortion services and penalties for those that contravene the country’s laws is old because it became effective around 1938.

“There was, therefore, a need to review the laws. As at now, the bill [Termination of Pregnancy], which is a product of the report the Special Law Commission came up with, is yet to be debated by Parliament.

“Current laws on termination of pregnancy are restrictive, in the sense that a woman is allowed to terminate pregnancy when her life is in danger. This means, without changing the law, some women will continue to be disadvantaged, which is not good because those with financial resources are able to seek the services elsewhere,” he said.

This state of affairs has worried people like human rights activist Emma Kaliya for ages.

More so because, according to her, the Rights of Women in Africa-Maputo Protocol (2003), which Malawi ratified in 2005, and other instruments, call on State parties to ensure that “the right to health of women, including that of sexual and reproductive health, is respected and promoted”.

States can do this by allowing women to control their fertility; decide whether to have children, the number of children and the spacing of children; right to choose any method of contraception; right to self-protection and to be protected against sexually transmitted infections, including HIV and Aids, among others.

Reverend Father Martin Kalimbe, who is also Religious Network for Choice Chairperson, is equally worried with the status quo.

He said, even in both Eastern and Western religions, women are only allowed to terminate pregnancy for therapeutical, eugenic and conception-without-consent reasons.

“Partly, this could be because St Thomas Aquinas wrote, in the 13th Century, a number of theological documents on the subject of when life begins and the church’s position on abortion.

“[However], the church does not serve as a conscience of society,” he said.

Meanwhile, as Malawians wait for a law that responds to the needs of women of child-bearing age, thousands continue to suffer, and die, at the hands of a system that was supposed to serve their interests.

But the statistics are there for all to see. For instance, as many as 67,300 induced abortions – ranging from 48,600 to 86,000–occurred in Malawi in 2009. Using data from 2008 Housing and Population Census and 2004 Demographic Health Survey, about 6,134 of women had spontaneous miscarriage, meaning that 32,094 women were treated for induced abortion complications in health facilities in Malawi in 2009.

A study conducted at Queen Elizabeth Central Hospital in Blantyre revealed that abortion complications accounted for 68 percent of admissions to gynaecological wards.

Further, research estimates indicate that 141,000 abortions occurred in Malawi in 2015— at an annual rate of 38 abortions per 1,000 women of reproductive age.

However, the abortion rate in Malawi varies widely by region. The abortion rate per 1,000 women aged between 15 and 49 years is highest in the Northern Region zone (61) and lowest in the Central Region (29).

The North zone has the highest unintended pregnancy rate at 135, and the Central zone has the lowest, at 123. These two had the lowest and the highest CPRs, respectively at 54 percent and 63 percent, according to the Malawi Demographic Health Survey 2015-16.

The Southern Region had the next highest abortion rate – at 39 induced abortions per 1,000 women aged between 15 and 49 years.

However, some of the women caught in this web die because they are poor and cannot seek abortion services in safe but expensive health facilities elsewhere, mainly due to society’s reluctance to accept that unsafe abortion is a time bomb that ticks throughout Malawi.

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