Zimbabwe Passes Revised Comprehensive Abortion Care Guidelines

The new guidelines are an update on the 2014 edition and expand abortion access to women within the parameters of existing law.

After more than 18 months of advocacy, the Zimbabwean Ministry of Health and Childcare (MoHCC) has passed revised Comprehensive Abortion Care Guidelines.

The revised guidelines include:

Recognition that women’s decision-making can be driven by socioeconomic factors such as financial situation, mental health, and family support (this is significant because it signals that the government supports expansion of the legal indications for abortion)
Guidance on Medical Abortion in line with World Health Organisation (WHO) recommendations – including a regimen for medication Letrozole, making Zimbabwe one of the first countries in Africa to approve Letrozole for Medical Abortion
Task sharing of first trimester services to nurses and midwives
Adoption of WHO pain relief regimens
Updating the national recommendation on Dilation and Curettage to be in line with WHO’s prohibition of the method, which is outdated and painful

Our MSI Zimbabwe programme, Population Services Zimbabwe (PSZ), played a significant role in this advocacy. PSZ worked with the Ministry of Health to convene a task force of key stakeholders to work on the guidelines, ensuring that professional associations were represented including the Zimbabwe Confederation of Midwives, Association of Obstetricians and Gynaecologists, and Zimbabwe Doctors for Human Rights.

PSZ shared recent Comprehensive Abortion Care guidelines from Nigeria and Post Abortion Care guidelines from Malawi, which both contained language that helped expand existing legal indications for abortion and increase the operating space for providers.

PSZ also helped convene one of the review retreats for the task force, where they provided technical guidance on Medical Abortion, Dilation and Curettage, counselling, decision making and task sharing.

The process took over 18 months and had several delays, including the 2023 election which stalled decision making. The Ministry of Health was also sceptical that the guidelines were needed – PSZ played a key role in overcoming this by helping the MoHCC draft a brief to make the case that they were essential.

Now they are approved PSZ has been working with the MoHCC to ensure that the Comprehensive Abortion Care guidelines are operationalised and implemented.

The PSZ Clinical Director participated in the first training of trainers session held by MoHCC. PSZ have also been instrumental in training providers on the new guidelines, including planning VCAT training with hospital administrators to encourage the adoption of the new guidelines by healthcare providers.

PSZ is also working with the National School of Nursing to build a buy-in for the revised training curriculums, so they are adopted as the national preservice training. This means all future nurses and midwives coming through the system will have been trained on the new guidelines.