Problem Analysis:

•  Abortion in Afghanistan is only permitted on medical indication to safe life of women, otherwise it’s not legal. In the case of Medical indication it can be performed through a process which includes certification of the case by three medical professional and approval of higher authorities from the Public Health Ministry.

• Although there is no exact data on unsafe abortion in the country, the rate of unsafe abortions are expected to be high, with most of them performed in unhygienic conditions and by unskilled providers. This can contribute to highest rate of maternal mortality rate globally (1600/ 100,000 live births) that unsafe abortion is on of the key causes.

• The awareness among general population on complication of unsafe abortion is low and poor quality of post abortion care services especially in rural areas and insufficient knowledge and skills of services providers on abortion related services increase abortion related problem.

Strategic Direction:

1. Increase awareness on the health and social justice impact of unsafe abortion through IEC/BCC, national advocacy and Post Abortion care  

Goal:

• Reduce Maternal Mortality Rate as result of unsafe abortion.

Objectives:

Objective 1:

• Reduce the incidence of unsafe abortion in the target population.

Objective 2:                                          

• Improve quality of abortion-related care services including post abortion care and counseling in AFGA Family Welfare Centers.

Activities:

Activities for objective 1:

1. Collect and record data on unsafe abortion e.g. undertake indicative research.
2. Undertake resource mapping exercise of key stakeholder’s e.g. RH providers, NGOs working with women/health for strategic partnerships.
3. Organize and conduct health education sessions for the clients in AFGA Family Welfare Centers on complications of unsafe abortion.
4. Develop target specific IEC/BCC strategies on increasing awareness tools including training of staff in their use to increase awareness on the impact of unsafe abortion and the need for abortion).
5. Increase capacity of staff to undertake IEC/BCC activities with target populations (including young people).
6. Establish strategic partnerships with key stakeholder (e.g. Ministry of Women’s Affairs/Public health) for national level advocacy, capacity building, etc.
7. Work with media to increase the broadcasting of information regarding the complications of unsafe abortion and the need for abortion.

Activities for objective 2:

1. KAP survey of staff and volunteers on safe abortion’
2. Design and deliver gender and safe abortion sensitization training with AFGA staff and volunteers.
3. Conduct capacity building needs assessment of AFGA clinic and develops training programmes (impact of unsafe abortion, management of unsafe abortion, post abortion care and counseling) for AFGA Family Welfare center staff.
4. Work in close collaboration with MOPH and other key stakeholders to review and revise protocols for safe abortion and abortion -related care to the extent permitted e.g. referrals (where permitted by law for safe abortion) and referrals for post abortion complications/PAC.
5. Provide quality post abortion care and counseling, including referrals to partners in cases of complications due to unsafe abortion. 

Outcomes:             

1. Increased awareness of the general population, especially women about the consequences of unsafe abortion leading to a reduction in the need for abortion.
2. Increased partnership with key stakeholders to work collaboratively to reduce the incidence of unsafe abortion in Afghanistan and providing quality post abortion care.
3. AFGA Family Welfare Centers provide quality post abortion care including referrals for post abortion complications from unsafe abortions.  

Indicators:

Indicators for objective 1:

• Reliable and accurate data on incidence of unsafe abortion in Afghanistan.
• Number and quality of advocacy literature produced e.g. position papers.
• Number of national level events held e.g. seminars, conferences, meetings;
• Number, range and quality of IEC/BCC tools developed and used with key target groups.
• Number of MOUs signed with line ministries and agencies for working jointly in abortion related programs.
• Changes in attitudes towards unsafe abortion by women, men and key community constituents.
• Communities able to talk openly about the need for abortion, especially unsafe abortion. Number of media events containing information and messages on complication of unsafe abortion (TV/radio programs, newspaper articles )

Indicators for objective 2:

• Number, range and quality of training conducted on pre and post abortion care and counseling for AFGA clinic staff.
• Protocols for Post abortion Care available in AFGA Family Welfare Centers and used by the staff.
• Number and type of services provided.
• Number and type of referrals made to range of partners.
• Number of books and guidelines on abortion related issues available in AFGA main Resource Center and used by the staff and volunteers.