New US policy to affect health care delivery


A new United States government policy to cut funding to organisations that support comprehensive reproductive health care in aid recipient countries threatens to impact negatively on health service delivery in poor nations, including Malawi.

This was revealed yesterday during a media roundtable in Nairobi, Kenya where experts from Population Action International (PAI) presented findings of their fact-finding trips to Ethiopia, Nigeria and Uganda on the early impact of the policy.

Rucks: It disrupts trusted and qualified providers

Known as the Global Gag Rule (GGR), the policy forces foreign non-governmental organisations (NGOs) to choose between receiving US global health assistance and providing comprehensive sexual and reproductive health care.

In her remarks, PAI president Suzanne Ehlers said the restrictions deprive women of their right to information and care, including contraceptives, cancer screening, routine health examinations and safe abortion services.

She said: “For Malawi, just as in other countries, the expanded policy under the Donald Trump administration will dismantle health systems, rise up unintended pregnancies thereby forcing women to seek unsafe abortions, and it will hurt the overall health communities.”

Ehlers said in the countries where PAI has documented preliminary impacts of GGR, health providers have been forced to trim staff, sever ties with key partners and close programmes, thereby limiting communities’ access to health care.

She said: “The evidence is clear—whenever and wherever this policy has been imposed, women’s lives have been endangered.”

In an interview, PAI senior director of advocacy Jonathan Rucks said the policy disrupts health systems.

“It disrupts trusted and qualified service providers by cutting them out of the system and when that happens, the individuals who rely on those service providers for their care or services lose access to those services. That is impacting the ability to provide the services in communities around the world,” he said.

Specifically, the GGR prohibits recipients of US family planning funding from providing abortion care, educating patients about abortion options, or making referrals to abortion providers.

In Malawi, abortion is restricted to only when a pregnancy puts the mother’s life at risk, leading to women often seeking clandestine ways of getting rid of unwanted pregnancies. Government is reported to spend millions of kwacha in post-abortion care for unsafe abortions.

Currently, there is a draft Termination of Pregnancy Bill that is yet to be tabled in Parliament. The bill proposes broader conditions under which abortion may be permissible, such as in the event of rape or incest.

The GGR is a trademark policy for Republican administrations, having been first announced in 1984 by former US president Ronald Reagan. President Donald Trump reinstated it on January 23 2017, soon after taking office.

The US government, through the United States Agency for International Development, is the largest donor for reproductive health services globally.

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