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Reproductive health and rights in post-revolution Tunisia
Abstract
From the launch of the national family planning program in 1964 (just eight years after independence) to the legalization of abortion in 1973 (without restriction as to reason in the first trimester) Tunisia’s policies and programs evince a longstanding national commitment to comprehensive reproductive health service delivery. Tunisia is widely regarded as a trailblazer in the developing world and exceptional within the Middle East and North Africa. The impact of this prioritization on reproductive health can be seen in Tunisia’s reproductive health indicators which are consistently the strongest in the region. Yet the election of Ennahda has sparked public debate about the future of reproductive health in Tunisia. To date, Ennahda has not enacted any legal or policy reforms regarding family planning, contraception, emergency contraception, or abortion. Indeed, that ulipristal acetate (a new pill-based form of post-coital contraception) is poised to enter the Tunisian market in 2014 through a regulatory approval process that took place after the November 2011 elections suggests that there is a continued structural commitment to reproductive health. However, rhetoric coming from Ennahda's leadership and the ongoing mobilization of Salafists are concerning for those advocating for the preservation of reproductive, sexual, and women's rights in Tunisia. Based on extensive ethnographic fieldwork, including periods of community residence and participant observation and engagement from 1997 through 2014, this paper explores reproductive health and rights in Tunisia with a specific emphasis on the post-revolution period. Through an examination of the policies shaping access to reproductive health services, discursive frames employed in the new political environment, emerging efforts by different stakeholders to ensure the preservation of reproductive rights, and experiences of unmarried and married women, this paper sheds light on the complexities surrounding reproductive health in Tunisia. The findings indicate that even in the absence of regulatory or policy changes, the socio-cultural space created in the wake of the revolution has already shaped women's experiences and created new localized barriers to accessing certain services. The inter-linkages between law and policy, service delivery, community organizing, and individual experiences suggest that the upcoming national elections will prove a watershed moment in the trajectory of reproductive rights and this paper concludes with reflections on the implications of the election outcomes for reproductive health.
Discipline
Medicine/Health
Geographic Area
Tunisia
Sub Area
None