Women around the world have faced multiple barriers to accessing safe abortion care during the COVID-19 pandemic including the de-prioritization of sexual and reproductive healthcare, overwhelmed health systems and restrictions on movement. The COVID-19 crisis has sparked innovation among IPPF Member Associations who responded swiftly by developing new approaches to reach women with safe abortion care including telemedicine and home-based provision of medical abortion. Strong evidence generated from this work supports the continuation and strengthening of these approaches beyond the end of the pandemic. Cameroon Cameroon National Planning Association for Family Welfare (CAMNAFAW) To ensure that quality abortion care can be provided to women during travel restrictions, CAMNAFAW’s service providers travel to partner clinics in underserved areas and to clients’ homes to provide medical and surgical abortion care. This model of taking safe abortion care closer to women will continue even with easing of travel restrictions, as this has been found to be an effective and acceptable approach to increasing access.Photo: IPPF/Xaume Olleros/Cameroon Share on Twitter Share on Facebook Share via WhatsApp Share via Email Guinea Association Guinéenne pour le Bien-Etre Familial (AGBEF) Building on lessons learned during the Ebola crisis in Guinea, AGBEF quickly took measures to prevent infection in its clinics to continue providing sexual and reproductive healthcare, including surgical and medical abortion, in a safe environment. AGBEF donated protective materials to communities, including hand-washing stations, face masks and antibacterial gel, alongside messaging on infection prevention. This community visibility reassures clients they can safely attend AGBEF clinics for abortion and contraceptive care.Photo: AGBEF/Guinea Share on Twitter Share on Facebook Share via WhatsApp Share via Email India Family Planning Association of India (FPA India) FPA India and partners advocated to have sexual and reproductive healthcare, including abortion, recognized as essential by the government, which meant FPA India could continue healthcare delivery during the national lockdown. To reduce in-person clinic visits, FPA India established teleconsultation and counselling for abortion care, and is continuing to provide in-clinic care for both medical and surgical abortion. Photo: IPPF/Alison Joyce/India Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nepal Family Planning Association of Nepal (FPAN) FPAN and partners advocated for interim approval of home provision of medical abortion and telemedicine for abortion counselling during COVID-19. FPAN is now implementing these approaches, ensuring continued access to abortion care in Nepal, where many people live in remote locations with limited mobility, which has been further restricted by COVID-19 lockdowns. Photo: FPAN/Nepal Share on Twitter Share on Facebook Share via WhatsApp Share via Email Pakistan Rahnuma – Family Planning Association of Pakistan (Rahnuma-FPAP) Rahnuma-FPAP and partners successfully advocated for the government to class sexual and reproductive healthcare as ‘essential’, which enabled the team to continue providing post-abortion care during the pandemic. Rahnuma-FPAP expanded its telemedicine and home-based provision for menstrual regulation counselling and post-abortion care. These new approaches have ensured continued access to services for clients unable to reach clinics.Photo: Rahnuma-FPAP/Pakistan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Palestine Palestinian Family Planning and Protection Association (PFPPA) In response to the government-mandated closure of its clinics, PFPPA quickly established a toll-free call centre which provides consultations, counselling, referrals and follow-up, including consultation for abortion care through a harm reduction approach, ensuring that women are provided with accurate information. Due to its success, PFPPA is exploring options for continuing this healthcare delivery model beyond the pandemic, with the aim of keeping it free of charge for users.Photo: SAAF/Samar Hazboun/Palestine Share on Twitter Share on Facebook Share via WhatsApp Share via Email Sudan Sudan Family Planning Association (SFPA) Following a nation-wide shutdown in April, SFPA  established  a call centre to increase access to healthcare, including abortion and contraceptive counselling and referrals.  An unexpected outcome of the new call centre is that it has reached an increased number of young women who regularly call to discuss their reproductive health and rights. SFPA  is working  towards institutionalizing this model for continuation beyond the pandemic.Photo: SFPA/Sudan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Togo Association Togolaise pour le Bien-Etre Familial (ATBEF) ATBEF adapted its mobile application ‘Infos Ado Jeunes’, adding a toll-free teleconsultation service for young clients to use to access abortion consultations and pre- and post-abortion counselling. This app has given young clients ongoing access to care when they face challenges travelling to clinics. It has also eased overall client flow in clinics at a time when social distancing is being implemented.Photo: ATBEF/Togo Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Comprehensive sexuality education (CSE) is a sex education approach that focuses not only on the reproductive aspects of sexuality, but also on the emotional and social aspects that young people need to determine their sexuality and thrive in their lives. CSE sees sexuality in a holistic way and in the context of emotional and social development and considers young people as sexual beings. The most recent national health survey carried out by the DHS program in Guinea has shown some severe issues which highlight young people’s need for good quality sexuality education. For example: 63% of girls get married before the age of 18 More than a quarter (26%) of adolescent girls are mothers 90.6% of adolescent girls have undergone female genital mutilation (FGM) The rate of HIV/AIDS is 50 times higher for girls than for boys More than a quarter (26.5%) of girls (aged 10-24) have experienced violence More than a quarter (26.1%) of adolescents and young people (aged 10-24) are out of school Indeed, despite the efforts made, sexuality remains a taboo subject for us in Guinea, because it is influenced by religions and customs, which creates reluctance, fear and refusal of information for young people, some of whom are already sexually active. Young people and adolescents still do not receive adequate services tailored to their sexual and reproductive health needs. Most families in Guinea do not dare to talk about sex at home. We must intensify the information in order to reach the most remote and disadvantaged corners of our communities. Family participation For full sexuality education to be achieved, it is necessary that everyone in the family participates and plays a role. This should challenge the Guinean state, technical and financial partners and all stakeholders to act quickly by intervening in favour of CSE in order to reduce the risks for young people and adolescents. I want to see my peers live fulfilled and responsible lives, through the provision of comprehensive sexuality education in school or extra-curricular (for example through parent-child dialogue). I want to see young people living in rural areas enjoy the same benefits in terms of information and intervention on sexual and reproductive health. I want to see young leaders involved in making decisions about youth access to CSE, because doing something for young people without young people is against young people. I hope that the integration of comprehensive sexuality education in training curricula, and sharing awareness through social media will be a considerable asset for young people in school. For young people out of school I hope to see regularly organized communication activities through educational talks, door-to-door sensitization, and daily media spots in national languages, while involving religious and community leaders. Starting at an early age Thus, it is important to start CSE at an early age because it is the only way for the child to know and control their own body, and, as the UNESCO International Technical Guidance shows; to delay first sexual intercourse, to reduce risk-taking and increase use of condoms and contraception, to reduce the frequency of sexual intercourse and the number of sexual partners among young people. I think that parents have a really important role to play in youth access to CSE in and outside of school. In short, parents must absolutely respond to their children's questions in a natural way. Although they should receive sex education in school, home education should not be missed because it is also important. If neither school nor parents talk about sex education to young people and adolescents, the situation will be deplorable. They are an essential point of contact and if they are well informed, they will be able to facilitate this process. Antoine Fassou Loua - Young Peer Educator at Association Guinéenne pour le Bien-Etre Familial, IPPF member association in Guinea.

As part of our work in tackling abortion stigma, IPPF awards small grants to young people to create projects that would tackle the issue of abortion stigma in their communities. In 2015, small grants were awarded to promising projects submitted by young people in Ghana, Palestine, Spain, Macedonia and Nepal. In 2017, a further six grants were awarded to young people in Guinea, Kenya, Nepal, Puerto Rico, Sierra Leone and Venezuela. In 2019 five more grants were awarded to youth-led projects in Albania, Colombia, Nigeria, Spain and Tanzania. These documents give more information about what these projects set out to do, their methods and the results.