Worldwide Laws and Policies on Contraception, Abortion and Sterilization Affect Service Provision

Abstract

Over the past decade, at least 30 countries began permitting nonphysician provision of pills and IUDs, conditions for contraceptive sterilization were relaxed in 42 countries, and grounds for legal abortion were extended in 42 countries, but 2 recent reviews by the IPPF and UNFPA indicate that laws and policies continue to hamper the provision of family planning services. Examples of legal actions cited by the IPPF handbook which affect family planning service provision include laws prohibiting advertising of contraceptives and laws governing necessity of doctor's prescriptions for sale of pills. The doctor's prescription requirements are gradually being eroded, as paraprofessional personnel are authorized to perform functions that were previously undertaken only by doctors. Issues to be resolved before paraprofessionals can be successfuuly used in family planning programs include delegation, authorization, interpretation of the law, training, qualifications, supervision, and adequate referral systems. Legislation pertaining to voluntary sterilization is often nonexistent or nonspecific, but restrictive codes apply in many countries. Although abortion laws remain restrictive in many countries, according to a recent estimate only 20% of the world's population currently live in countries where abortion is prohibited or permitted only to save the life of the woman. In many countries family planning services are particularly restricted for adolescents.