Ipas works globally with a vision that every woman and girl has the right and ability to determine her sexuality and reproductive health. It seeks to expand the availability, quality, and sustainability of abortion and related reproductive health services, as well as improve the enabling environment for the services. Ipas believes that no woman or girl should have to risk her life or health because she lacks safe reproductive health choices. Access to sustainable and safe abortion comprises of various factors and actors cutting across the standalone health lens.
These actors and factors based on the principle of human rights from the onset of programs, policies, and projects formulate a sustainable ecosystem. The introduction of the human rights-based approach to health aims to realize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (right to health) and other health-related human rights through the interrelated and essential elements of availability, accessibility, acceptability, and quality (AAAQ).
To achieve balance and ensure a committed, responsive system for abortion care, Ipas is implementing a project called ‘Strengthening the Safe abortion Ecosystem in Nepal’ in line with Ipas Sustainable Ecosystem Framework, a dynamic condition by local stakeholders addressing multiple components to truly meet women’s safe abortion service needs keeping women centered care in the center of the program.
Intertwined with the programming components are the existential gender and social norms which might act as restraining or driving forces for sexual and reproductive health and rights (SRHR) services. In addition to the prevalent social norms and knowledge among women, there are “other” factors or actors which might hinder the efforts to increase utilization of SRHR services by women and girls. It was felt important to understand the impact of such forces which are interlinked to the smooth implementation of program and increase access to services.
For this, Ipas used Force Field Analysis (FFA) and Social Norms Analysis Plot (SNAP) approaches to identify the associated social norms and other factors on selected program districts. The FFA provided the overall power structure and the position (agency, structure, or relations) where the power is stored to understand its navigation towards the positive or negative side for SRHR and safe abortion. SNAP helped to analyze how this power influenced the continuity of the harmful social norms.
In simple terms, by creating an inter-connectivity between both the tools, FFA helped Ipas develop a strategy regarding who and how it should work with, while SNAP helped us dissect the social norms that are inhibiting or driving these forces of power and implement the demand side activities and messaging. Two clusters from the interventions Palika of Province Lumbini and Sudurpaschim were selected. The clusters were selected based on the principle of social inclusion (marginalized and vulnerable areas) geographically remote and hard to reach for services.
The FFA was conducted with community women and girls of reproductive age whereas SNAP was conducted with the same participants from FFA along with the Men and Boys group 4 FFA and 3 SNAP tools were used in each selected areas. The findings of the study were crucial in identifying the areas of gender and social norms integration and guiding the pathway of the programs.