12 | wileyonlinelibrary.com/journal/ijgo Int J Gynecol Obstet 2018; 143 (Suppl. 4): 12–18 DOI: 10.1002/ijgo.12672 SUPPLEMENT ARTICLE Aboron as a human right: The struggle to implement the aboron law in Colombia Bianca M. Sfani 1, * | Laura Gil Urbano 2 | Ana Crisna Gonzalez Velez 3,4,5 | Crisna Villarreal Velásquez 6 This is an open access arcle under the terms of the Creave Commons Aribuon IGO License which permits unrestricted use, distribuon and reproducon in any medium, provided that the original work is properly cited. In any reproducon of this arcle there should not be any suggeson that WHO or the arcle endorse any specific organizaon or products. The use of the WHO logo is not permied. This noce should be preserved along with the arcle’s URL. © 2018 World Health Organizaon; licensed by John Wiley & Sons Ltd on behalf of Internaonal Federaon of Gynecology and Obstetrics. 1 Department of Obstetrics, Gynecology and Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center, New York, NY, USA 2 Fundación ESAR, Bogotá, Colombia 3 Grupo Médico por el Derecho a Decidir en Colombia, Bogotá, Colombia 4 La Mesa por la Vida y la Salud de las Mujeres, Bogotá, Colombia 5 Global Doctors for Choice, New York, NY, USA 6 Fundación Oriéntame, Bogotá, Colombia *Correspondence Bianca M. Sfani, Albert Einstein College of Medicine/Montefiore Medical Center, New York, NY, USA. Email: bsfani@montefiore.org Funding Informaon UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproducon (HRP) Abstract In 2006, a Colombian Constuonal Court decision legalized aboron in cases of risk to a woman’s physical or mental health, fetal malformaon incompable with life, or rape or incest. This decision resulted from legal acon brought by feminist groups, and frames aboron as a human right. Advocates played a key role in implemenng the new law by educang providers and the public about its broad interpretaons. Healthcare providers and facilies did not have an organized response to the new law. Nonprofit organizaons filled this gap, and provide a majority of legal aborons throughout the country. Civil society facilitated implementaon of the new law by providing legal accompaniment to women facing barriers to accessing aborons. Despite these efforts, few legal aborons are performed each year, and clandesne, oſten unsafe aborons connue to prevail. Lack of informaon about the new law, sgma, and fluctuang polical will remain key barriers. KEYWORDS Advocacy; Colombia; Human rights; Implementaon; Legalizaon; Public health; Safe aboron METHODOLOGY FOR ALL CASE STUDIES This case study is one of six comprising a comparave examinaon of varied countries’ approaches to the implementaon of naonal aboron service programs, following changes in laws or policy guide- lines that established or expanded access to services. In addion to Colombia, case studies were conducted in Ghana, Ethiopia, Portugal, South Africa, and Uruguay, as they had all either implemented new aboron laws or policies, or changed interpretaons of exisng laws or policies, within the past 15 years. Each study used the Integrated Promong Acon on Research Implementaon in Health Services (i-PARIHS) framework to organize the analyses. i-PARIHS posits successful implementaon to be a funcon of the innovaon to be implemented and its intended recipients in their specific context, with facilitaon as the “acve ingredient” aligning innovaon and recipi- ents. 1 For each country case, two types of data sources were used: an in-depth desk review and 8–13 semistructured, in-depth interviews with key stakeholders and experts in each country, selected in col- laboraon with in-country partners. Respondents provided wrien informed consent and were guaranteed confidenality. Several respon- dents from each country served as in-country coauthors, in doing so giving up their anonymity as parcipants of the study, although no quotaons provided as respondents are directly aributed to them. Respondents included healthcare providers, public health and govern- ment officials who had been involved in establishing or expanding the service, academics, and members of nongovernmental organizaons (NGOs) and legal and feminist advocacy groups; in some countries interviewees came from the full range listed, in others, from a subset
Abortion as a human right: The struggle to implement the abortion law in Colombia
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