| Issue/Objective |
Unsafe abortion remains a major preventable cause of morbidity and mortality in Latin America, even after reforms that expanded the legal grounds for abortion in several countries. In many settings, one of the main bottlenecks is no longer the legal indication but provider regulation: abortion care is reserved for physicians, who are concentrated in urban and tertiary facilities. This paper examines provider eligibility rules as a structural barrier to equitable access and argues that task sharing is a missing piece in the implementation of abortion law reform across the region. |
| Methodology/Approach |
The study applies a comparative legal methodology within a global health framework, combining three strands: a review of peer-reviewed literature and WHO guidance on task sharing; a comparative analysis of abortion-related norms in 14 Latin American countries, including penal codes, statutes, ministerial regulations, and clinical protocols defining provider authorization; and an in-depth examination of recent reforms in Mexico, Colombia, Argentina, and Ecuador, focusing on how provider roles are allocated and on the public health, equality, and intercultural rationales advanced in support of more inclusive frameworks. |
| Results |
Ten of the 14 countries reviewed maintain physician-exclusive frameworks that exclude mid-level providers from service delivery, despite robust clinical evidence supporting their active role. In nine, physician exclusivity is embedded in legislation, making reform politically and procedurally demanding. These frameworks tie service delivery to a scarce, unevenly distributed professional group, structurally constraining access. By contrast, Mexico, Colombia, Argentina, and Ecuador have moved toward broader provider models that incorporate nurses, midwives, and Indigenous and community-based practitioners. |
| Discussion/Conclusion |
Task sharing, understood as a public health strategy that redistributes abortion-related tasks across a broader range of trained health workers, emerges as a concrete implementation challenge at the intersection of equity and reproductive health governance. A regional reform agenda should align domestic regulations with WHO recommendations, harmonize provider rules across regulatory frameworks, and invest in competency-based training and service organization, so that expanded provider roles translate into real access on the ground. The paper aligns with Sub-theme 3 by translating evidence into legal and regulatory reforms that strengthen health systems, improve accountability, and support equitable implementation of abortion law. |
| Presenters and Affiliations |
Dana Repka International Reproductive and Sexual Health Law Program, University of Toronto |
