Submission ID 131293
| Issue/Objective | Legal frameworks act as important structural determinants of maternal health and reproductive autonomy. In 2021, Benin amended its law on sexual and reproductive health, significantly expanding the conditions for accessing abortion and positioning the country among the most progressive in sub-Saharan Africa in terms of reproductive rights. However, the experience of other countries shows that in similar contexts, the implementation of abortion law reforms often remains incomplete, with insufficient improvement in access to safe abortion. In Benin, the implementation level of the amending law remains undocumented; this study aimed to determine and understand it. |
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| Methodology/Approach | Two health departments were selected including one urban (Littoral) and one rural (Collines). In october 2025, 24 semi-structured individual interviews were conducted with four civil society organization (CSO) managers and 20 health providers from public, private and nonprofit sectors. Two focus group discussions were conducted with six community-level CSO actors each. Participants were selected by convenience and snowball sampling until saturation was reached. Interviews and focus groups were recorded, audio files were transcribed and an inductive-deductive thematic analysis with MaxQDA was conducted. |
| Results | The law's implementation level varied across sectors with the nonprofit sector followed by the private sector demonstrating higher implementation levels than the public sector. CSOs played a central role in supporting the implementation. Most providers reported effectively providing abortion services and applying the new law. However, three providers worked in facilities that opted out of providing abortion services due to institutional conscientious objection. When conscientious objection was invoked, legal requirements, including declaration of status and referrals, were often not applied. The law's vague and subjective grounds also led to variations in its application with a stricter assessment of eligibility in the public sector. Attempts to dissuade women from having abortions were frequent, as well as the imposition of additional conditions to access abortion. Despite obstacles, most providers reported an increase in demand for safe abortions combined with a decrease in severe complications of unsafe abortions, since the law's adoption. |
| Discussion/Conclusion | Despite incomplete implementation, the law was still accompanied by reported improvements in public health. Strengthening its implementation could lead to substantial gains in maternal health. |
| Presenters and Affiliations | Lalique Browne University of Montreal Marius Kêdoté Institut de Recherche en Santé publique (IRSP) Comlan-Alfred Quenum Thomas Druetz University of Montreal |
