Ipas Zambia 2018-2021 Ipas Zambia 2018-2021 "‘Promoting Sexual and Reproductive Health and Rights and Reducing Maternal Mortality in Zambia " was first implemented in Luapula and Muchinga provinces and then expanded to Eastern and Sounthern Provinces of Zambia. Implementation period 2018-June 2022. The intervention aims at improving awareness of and access to a continuum of quality sexual and reproductive health and rights information and services, including comprehensive abortion care, by women and girls in the two provinces by 2021 through:  1) Health systems strengthening to increase the provision of quality comprehensive abortion care (CAC) services, including post abortion family planning (PAFP)and  2) Community awareness and mobilization to increase knowledge, awareness, access, and social support for CAC services among community members. Ipas Zambia will work with the Ministry of Health at all levels to ensure that implementation is conducted in line within the approved guidelines and legal framework and to ensure complete ownership of the programme by the government. The intervention’s total budget is 42 million SEK. Ipas Zambia har ansökt om finansiering från Sida till ett värde av SEK 27 000 000, för att genomföra programmet "Promoting Sexual and Reproductive Health and Rights and Reducing Maternal Mortality in Zambia" i Luapula och Muchinga provinserna, under perioden 2018-2021. Insatsens syfte är att bidra till att kvinnor och flickor får bättre förståelse för, och tillgång till kvalitativ information och tjänster inom sexuell och reproduktiv hälsa och rättigheter. Ipas Zambia hoppas uppnå detta genom att; 1) bidra till förbättrad tillgång till kvalitativa hälsotjänster – specifikt inom olika former av abortvård och familjeplanering, 2) bidra till att samhällen får ökad förståelse och kunsap om och tillgång till abortvård, samt ökat socialt stöd för abortvård. Ipas Zambia kommer att samarbeta med hälsoministeriet för att säkerställa att implementering sker i linje med godkända riktlinjer och bindande ramverk, och för att säkerställa nationellt ägandeskap. Insatsens totala budget är SEK 28 000 000. This three-year project includes the foundational steps to establish the necessary guidelines and health system infrastructure to make comprehensive abortion and contraceptive services accessible to women and especially to girls in Zambia over the long term. Ipas have the opportunity to provide technical assistance and support to the MOH in its RMNCAHN work to prevent injuries and deaths of women especially adolescents from unsafe abortion and, more broadly, to advance the sexual and reproductive health and rights of especially poor women and adlescent girls in two very poor provinces of Zambia.
1.Health systems will be strengthened to increase the provision of quality comprehensive abortion care (CAC) services, including postabortion family planning (PAFP), in Luapula and Muchinga provinces.2. Ipas will raise ommunity awareness and mobilization to increase knowledge, awareness, access, and social support for CAC services among community members in the two provinces.
The intervention intends to minimise the high rate of maternal death due to the problem of unsafe abortion,especially amongst adolescent women,which remains a major problem in Zambia and in particular the two poverty stricken provinces of Luapula and Muchinga. The Zambian MOH has estimated that as many as 30% of pregnancy-related deaths could be attributable to unsafe abortion, while hospital-based studies show that 30% to 50% of acute gynecological admissions are currently caused by abortion complications, a sizable proportion from unsafe abortion. The MOH also estimated that about 23% of incomplete abortions were among women younger than 20 years and that 25% of maternal deaths due to induced abortions were among adolescent girls younger than 18 years. While modern contraceptive uptake is generally low in Zambia, with a national average of 45%, the situation is worse in both Muchinga and Luapula where contraceptive uptake is only 34% and 33% respectively. Muchinga and Luapula provinces have the highest total fertility rate of Zambia’s provinces except Northern Province. No safe abortion services exist in the two provinces for women who need them. PAC is offered only in hospitals that represent 4% of all public health facilities in these provinces, making the service largely inaccessible by vulnerable women and adolescent girls.
Increasing contraceptive use and availing CAC services will reduce both unwanted pregnancies and decrease maternal mortality especially amongst young poor women. Success of the intervention will depend on the interplay of acceptance of the programme,quality service provision by the health facilities and working within the legal framework.