Global gag rule6/16/2023 ![]() With a population at approximately 180,000, Kibera is East Africa’s largest slum, a bustling valley of tin roofs that cover small homes, schools and offices, with inefficient or non-existent sewage systems many people rely on getting access to sexual health services. Mary, who has been a volunteer for FHOK’s Family Care Medical Centre in Kibera since 2012, says that one of the consequences of GGR in Kenya was that it had hindered “getting commodities and supplies like condoms, IUDs” and that people had lost their jobs. Healthcare services reduced or forced to close Clinical Officer Adillahi Ali, checks baby Fatma as she sits with her mother Anisa, at The Family Care Medical Centre (FHOK) in Malindi, Kenya It means that critical funding is blocked for other sexual and reproductive services like contraception, maternal health, and HIV prevention and treatment. funding to organizations like Family Health Options Kenya (FHOK) if they use any money to provide abortion services, counselling or referrals. Since GGR was re-introduced by this US administration on January 23rd 2017, Mary says she has seen a rise in sexually transmitted infections (STI’s), especially syphilis, as well as an increase in unsafe abortions. Over the last two years she has seen first-hand the impact of the Global Gag Rule (GGR). To answer these questions, we partnered with local research institutions in three countries with diverse cultural and abortion-related legal contexts: Madagascar, Nepal, and Kenya. In each country, our partners interviewed stakeholders at multiple levels of the health system, including government officials, NGO program managers, SRH service providers, and clients who both accessed and were denied SRH services. GHJG also led a series of interviews with bilateral and multilateral funding agencies, foundations, and civil society organizations, in order to shed light on the extent to which the GGR affected organizational policies and funding levels at the global level.Single mother of five, Mary Mukuhi, is a businesswoman and family planning volunteer in one of Nairobi’s biggest slums, Kibera. This expansion meant that the policy could affect non-USG funding, and NGOs that did not receive any US global health assistance.īetween 20, with generous grant support from the William and Flora Hewlett and the David and Lucile Packard Foundations, GHJG implemented a three-country study to assess the impacts of this expanded Global Gag Rule. The primary objective of this research was to answer the question, “How does the expanded GGR affect provision of and access to SRH services?” Additional research questions explored the impact of the expanded GGR on multiple domains, including funding, policymaking, advocacy, service delivery, referral networks, and health systems. An additional expansion of the policy announced in March 2017 required GGR-certifying NGOs to flow the policy down to organizations they provide sub-grants to, irrespective of the funding source. Family Planning Assistance, the Trump administration’s expanded GGR extended these restrictions to nearly all global health assistance - including funding for HIV/AIDS and infectious disease, maternal and child health, nutrition, and water, sanitation and hygiene (WASH). Whereas prior iterations of this policy applied only to U.S. global health assistance. U.S.-based NGOs must ensure GGR compliance from foreign subgrantees. ![]() The GGR forces foreign NGOs to choose either to certify the policy and alter activities and funding relationships in accordance with its restrictions or become ineligible for U.S. Trump reinstated and dramatically expanded the Mexico City Policy, also known as the Global Gag Rule (GGR). When in place, this policy requires foreign (meaning not US-based) nongovernmental organizations (NGOs) to certify that they will not use funding from any source to “perform or actively promote abortion as a method of family planning” as a condition of receiving U.S. Assessing the Impacts of the Expanded Global Gag Rule
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