Title : Scaao regional expert group: A South–South model to strengthen quality and access to safe abortion care in Francophone Africa
Abstract:
Access to safe abortion care is a critical component of women’s health and an important determinant of maternal morbidity and mortality. In several Francophone African countries, access to quality abortion-related services remains constrained by restrictive legal environments, persistent stigma, and provider attitudes influencing the delivery of Sexual and Reproductive Health (SRH) services. These normative barriers affect quality of care, delay timely service utilization, and increase risks associated with unsafe abortion. Values Clarification and Attitude Transformation (VCAT) is recognized as an effective strategy to promote respectful, evidence-based and person-centered care in gynecological and reproductive health services. However, limited availability of qualified facilitators and absence of structured mechanisms for dissemination of expertise have slowed its scale-up across Francophone Africa.
Under the comprehensive abortion care in West Africa (SCAAO) program, a regional expert group coordinated by ABBEF was established to strengthen technical capacity and support institutional change among Member Associations in four Francophone countries. This implementation aimed to improve the enabling environment for quality safe abortion care through a structured South–South collaboration model. The intervention focused on strengthening a regional expert group able to provide contextualized technical assistance, expanding the pool of qualified trainers for national replication, promoting institutional ownership of VCAT, and strengthening multisectoral engagement to improve SRH service quality.
A multi-country implementation approach was conducted between 2024 and 2025, combining establishment of the regional expert group, regional Training of Trainers (ToT), and national VCAT workshops. The expert group included medical, legal, and programmatic specialists from member associations and provided continuous technical support to harmonize training approaches and ensure quality standards. The regional training expanded the group by adding 12 regional trainers using adult learning methodologies including experiential learning and co-facilitation. These experts supported national workshops targeting gynecological care providers, policymakers, youth leaders, civil society actors, religious leaders, and legal professionals. Data were compiled from training reports and program monitoring tools across four countries.
The regional expert group created a functional knowledge transfer mechanism enabling progressive integration of VCAT into SRH programs in legally and socio-culturally sensitive environments. Expansion of the expert pool supported replication and contributed to training more than 120 key stakeholders, including 68 parliamentarians in Togo, 16 senior technical officials in Cameroon, and 40 regulatory professionals in Burkina Faso. In Niger, technical support contributed to training 179 stakeholders, including 43 national VCAT trainers forming a sustainable national capacity. Participants included Ministry of Health officials, health providers, legal experts, religious leaders, and youth representatives. In a context initially characterized by institutional sensitivity, the progressive and evidence-informed approach supported institutional ownership of VCAT as a lever to improve quality of care and reduce barriers to safe abortion services.
This South–South regional expert group model shows strong transferability in similar health systems facing normative constraints affecting women’s access to reproductive health services. By strengthening regional expertise and national capacity, the approach contributes to improved quality of gynecological care and more equitable access to person-centered safe abortion services in Francophone Africa
