“Don’t do it, but do it” : Exploring a legal window of opportunity for safe abortion and the role of healthcare practitioners in implementing the right to health in Ethiopia

Sammanfattning: Unsafe abortion is a major contributing factor to maternal mortality with 47,000 largely avoidable deaths occurring globally every year, the majority in the global south. Ethiopia has taken a unique approach to addressing maternal mortality impacted by unsafe abortion through a 2005 reform of the abortion legislation in which abortion is illegal but available under a range of exceptions. The purpose of this thesis is to bridge health and human rights perspectives by approaching abortion through a right-based perspective and investigates how healthcare workers work towards the fulfilment of the right to health through safe abortion implementation in Ethiopia. Through a thematic analysis of 10 semi-structured interviews and Lipsky’s theory of street-level bureaucracy, the results reveal that views on abortion sit on a spectrum which reflect the 2005 legislation and that healthcare workers play a key role as gatekeepers for abortion access. Further, the analysis shows the importance of civil society actors for the fulfilment of the right to health. The study concludes that abortion is still stigmatised both by health providers and users but the argument of abortion as a life saving procedure is increasing acceptability.