Las Iniciativas: A Uruguay community empowerment model that reduces harm and stigma from unsafe abortions

Despite significant legal restrictions on abortion, since 2004 the Ministry of Health of Uruguay has allowed healthcare providers in public hospitals to offer pre and post abortion information and counseling to women, as well as information on how to correctly and safely use misoprostol, an effective medicine for abortion. This initiative is predicated on the beliefs that the national health system has an obligation to recognize and include a range of options for women regarding their reproductive health, and that women have the right to information and knowledge. A key component of this harm reduction model is ensuring that communities are empowered to use health counseling and services. A community intervention was initiated in 2008 to empower free and responsible decision-making in sexual and reproductive health, increase gender equality, promote the rights of citizens, and increase community participation in reproductive and sexual health. The community network that emerged from this project integrates health professionals with community activists and the team from the organizations who implement the project, and supports activities such as forums, cinema, workshops, community talks and medical consultations on the streets. This presentation will review this innovative community and citizenship empowerment model and its impact at the community level, including increased utilization of health services, increased confidence in healthcare providers, and increased knowledge about reproductive health. This project demonstrates how a community harm reduction model can address stigma and strengthen the ability of communities to define quality of and increase access to pre and post abortion services.