How to use locally-sourced data to ignite conversations at the council level

There were several challenges faced in addressing unsafe abortion in Magu District. Cultural stigma and sensitivities surrounding the topic made it difficult to openly discuss reproductive health issues, particularly unsafe abortion and thus few survivors were able to report to hospital for post-abortion care (PAC). Additionally, there was a lack of locally owned and accessible data on maternal mortality and unsafe abortion, which hindered effective advocacy. Some local leaders initially viewed reproductive health issues like unsafe abortion as as moral concerns rather than public health challenges, which slowed engagement in policy discussions. There was also a knowledge gap among ward councillors, who were not fully aware of the impact of unsafe abortion on their communities and their role in ending unsafe abortion. Fear of political backlash and resource constraints further complicated the situation. However, through data-driven dialogues and awareness-building efforts, advocates were able to discuss and acknowledge the gap while shifting perspectives, reframe the issue as a public health matter, and empower local leaders to take action and advocate for safer reproductive health practices.

While these challenges can not be currently declared tackled, but there is a progress towards positive dialogues in ending unsafe abortion and maximal availability and access to modern family planning items.

Outcomes observed in the workshop:

1. Ward councillors and district officers shifted from viewing unsafe abortion as a moral issue to recognizing it as a public health concern, which is crucial for shaping policy and action.
2. Participants began to view themselves as key persons to support for safer reproductive health practices and were more motivated to support changes at the council level.
3. Ward counsellors committed to keeping the talk about the impact of unsafe abortion during their meetings for locally relevant plans with clear steps for taking action to reduce unsafe abortion and improve reproductive health in their districts.
4. District officers became more engaged in data collection and collection of untold stories, resulting in improved monitoring of unsafe abortion trends and better-informed decision-making regarding reproductive health interventions. If they are well informed about the data, it is possible for them to continue with conversations in this aspect.

The organization learned several important lessons from this experience:

1. Locally sourced data that is participatory collected is vital for informing conversations and driving action.
2. Cultural sensitivity was another key takeaway. Framing sensitive issues like unsafe abortion and modern family planning within a public health context, rather than a moral one, helped avoid stigma and focused on health outcomes.
3. We also recognized the importance of engaging local leaders, especially ward councillors, in advocacy efforts, as they play a crucial role in promoting change at the grassroots level. The experience emphasized the need for patience, continuous engagement, and collaboration with local health teams.
4. One-time interventions were insufficient, and sustained efforts are necessary to ensure lasting change and integrate reproductive health issues into broader community health agendas.

1. Our team worked closely with the focal persons for GBV and reproductive health from the council team to collect data related to GBV, unsafe abortion and maternal mortality and other overlooked impacts among the few, this was to improve data collection and increase data ownership. With the available data, we highlighted them as public health challenges to women and adolescent girls rather than moral issues.
2. We also collected stories of change from survivors of unsafe abortion in the community. This made the participants have an emotional attachment of the impact that is also unreported.
3. We framed our discussions on neutral language around maternal health, gaps in reproductive health targeting to improve health outcomes.
4. The councillors were the primary participants to take lead in highlighting challenges and offer possible local based solutions through an open dialogue.
5. As facilitators, we facilitated the dialogue to be tied to the current practices and policy priorities. While enlighting the role of ward councillors in supporting better health outcomes.

By equipping local leaders with accurate data and culturally sensitive communication skills, advocates can significantly shift perceptions and create long-term change at the grassroots level.