Introduction
This paper explores the complex relationship between abortion laws, policy and women’s access to abortion services with a focus on three different legal and political contexts. It is broadly acknowledged that legal frameworks are vital instruments for securing the right to health [
1‐
3] but, as we will discuss in this paper, the connection between law, health policy and access to health services is complicated and critically dependent on the socio-economic and political context of implementation. Unsafe abortion, which is closely linked to restrictive abortion laws, and lack of access to contraception and safe abortion services, is a global problem of huge dimensions [
3]. With an estimated 22 million cases annually, unsafe abortion is a major contributor to maternal mortality and morbidity [
4], and between 4.7–13.2% of maternal deaths globally are estimated to result from unsafe abortion [
5].
In sub-Saharan Africa, deaths due to usafe abortions have increased steadily since the 1990s [
6], and the proportion of unsafe abortion to maternal death is estimated as high as 30% [
7]. Young women in low income countries, and particularly adolescents living in rural areas, are disproportionately represented in the statistics [
4] making unsafe abortion a massive inequity problem. Despite the scale and seriousness of the challenge, the controversial nature of the issue has pushed abortion to the margins of the global health agenda, and has made it one of the most neglected sexual and reproductive health problems in the world today [
8]. Surrounded by stigma and neglect, the high rate of unsafe abortions has been referred to as a ‘silent pandemic’ [
9]. The lack of access to safe and legal abortion is a major cause of unsafe abortion in many countries [
8], but moral and religious contestations hinder political commitment and the legal reforms necessary to address the problem.
There is strong evidence that restrictive abortions laws do not reduce the prevalence of abortion [
8]. Nonetheless, in most sub-Saharan countries, abortion continues to be illegal except to save the life of the pregnant woman, and criminal punishments are often prescribed for violations of these restrictions [
3]. Conversely, a liberal abortion law is not sufficient to secure access to safe abortion services. Political will and the resources to finance and build services and to secure awareness about the services remain key elements [
8]. Whether the law is liberal or restrictive, abortion is commonly stigmatized and frequently censured by political - and religious leaders, and a public stigma of abortion pervades local discourse in sub Saharan Africa. While both Christianity and Islam represent induced abortion as an act against the will of God, a broader global anti-abortion movement also condemns abortion on broader moral and philosophical grounds, arguing for the right to life of the unborn child. The moral stand against abortion has been challenged by the pro safe-abortion position, commonly defining safe abortion as part of Sexual and Reproductive Health and Rights (SRHR). The International Conference on Population and Development (ICPD) Programme of Action in 1994 [
10] urged all governments and organizations to “strengthen their commitment to women’s health” and “deal with the health impact of unsafe abortion as a major public health concern” ([
11], par 8.25). The following year, the Fourth World Conference on Women convened in Beijing moved one step further, stating that unsafe abortions threaten the lives of a large number of women, representing a grave public health problem. A plea to decriminalize abortion was agreed upon which referred to the ICPD Programme of Action for solutions [
12]. In 1999 the ICPD+ 5 Conference Programme of Action moreover strengthened a call for post abortion care to recognize and deal with the health impact of unsafe abortion as a major public-health concern. The programme of action emphasized the importance of reducing the number of unwanted pregnancies through the provision of family planning counselling, information and services, and by ensuring that health services are able to manage the complications of unsafe abortion [
13]. Post abortion care (PAC) - a concept initially launched by IPAS in 1991- was by and large not a very controversial concept and was gradually implemented globally. The diverse anti-abortion and pro safe-abortion movements and their attendant discourses, encountered on global, national and local levels, provide vital contexts for exploring the dynamics between national law and policy, and access to safe abortion services.
The study of the dynamics between national law and policy, and access to safe abortion services, requires critical engagement with discourses and movements for or against such access. Walt, Gilson and colleagues [
14,
15] have for decades been preoccupied with the contextualization of health policy analysis, and have, not least, focused on how to carry out policy analysis in low and middle income contexts. In their writings they have addressed how the development and implementation of policy depends on the interplay between policy actors, context, process and content. They argue that there has been a tendency of researchers to focus on policy
content alone, diverting attention away from the webs of
actors who are located at the core of policymaking, the
processes which explain why particular outcomes emerge or fail to emerge, and the particularities of the
contexts within which policy is formulated and implemented [
14]. Their ‘policy triangle framework’ is grounded in a political economic perspective, and considers how all of these elements (policy context and content, policy actors, and processes) interact to shape policy-making (ibid).
Similarly, calling for context-based public policy research focusing on the webs of actors who develop and implement policy, Wedel et at [
16], Shore and Wright [
17] and Shore, Wright and Però [
18] criticise approaches in policy research that are based on the assumption of ‘policy’ as an orderly and legal–rational way of ‘getting things done’. They argue that such research is likely to miss out on the struggles over meaning, and the complexity of negotiation that are inherent to policy-making. The authors call for research that focuses on competing narratives and on socially produced and messy policy-making [
18]. A central factor in making sense of the disorderly dimension of policy processes is that policy is no longer formulated primarily - or at least not only - by governments, but by a plethora of actors including supranational entities, NGOs etc. It may consist of webs of loosely connected actors located at multiple sites with varying degrees of institutional leverage [
16,
18]. The differently positioned actors will be vested with different interests and power vis-à-vis the issue in question [
19].
Inspired by such critical social science approaches to policy and policy implementation, which pay attention to the interplay between actors, contextual complexity and the ‘messiness’ of policy processes, this paper seeks to make sense of the articulation between abortion laws and policy, the implementation of such law and policy, and girls’ and women’s actual access to safe abortion services in three different contexts. In a comparative case study in Ethiopia, Tanzania and Zambia, we studied abortion-related law and policy documents, and explored how differently positioned actors within the field of abortion, interpret and act upon the (changing) landscapes of national abortion law and policy. The research is based on sub-studies within the Research Council of Norway funded project: Competing discourses impacting girls’ and women’s rights: Fertility control and safe abortion in Ethiopia, Tanzania and Zambia (2016–2018).
The three country contexts
Ethiopia, Tanzania and Zambia were chosen as cases for this study. They share a dominant anti-abortion discourse embedded in cultural and religious anti-abortion sentiments, but their legal frameworks for abortion are starkly different, making them interesting comparative cases.
The centrality of religion to people’s lives is a key feature of all three countries, and so is the role of religion in policy processes, not least pertaining to issues of sexuality and reproduction. In Zambia, where the churches have been influential since independence, the entangled relationship between politics and religion became particularly explicit when Zambia was declared a Christian nation in 1991 [
20,
21]. In Ethiopia, the Ethiopian Orthodox Tewahedo Church is the largest (44%), with significant minorities of Muslims (34%), protestants and evangelical Christians [
22], while in Tanzania approximately 35% belong to the Muslim- and 60% to the Christian communities [
23]. Alongside powerful religious institutions with anti-abortion ideals and positions, an intricate web of national- and international institutions and organizations working to promote access to reproductive health services are present in all three countries. These organizations may be working for services in the entire country but are, by and large, based in the largest urban centres. These webs of actors commonly hold pro-safe abortion positions.
In spite of highly varied historical, social and political contexts, all three countries demonstrate high fertility rates varying from 4.1 in Ethiopia to 5.0 in Tanzania [
24] and high maternal mortality ratios varying from 224 in Zambia to 398 in Tanzania [
25‐
27]. The contraceptive use varies from 41% in Zambia to 25% in Tanzania, and among teenage girls it varies from 28% in Zambia to 9% in Ethiopia (cf table below).
The three countries share the problem of high unsafe abortion rates reflected in an extensive use of PAC services, but the social stigma associated with abortion and the difficulties of distinguishing between induced abortion and miscarriage cause data to be scarce and highly uncertain [
28]. National data for Zambia are not available, but records from five major hospitals across the country between 2003 and 2008 show that almost one-third of all gynecological admissions were due to complications of unsafe abortion, and it is estimated that 6 in every 1,000 of these women died as a result of their complications [
29]. In Ethiopia estimates indicate that despite the availability of legal abortion services, one third of adolescent abortions are clandestine and thus potentially unsafe [
30]. There are strong indications that abortion related deaths have been reduced after the revision of the law in 2005, and recent estimates indicate that complications from unsafe abortions account for 19.6% of all maternal deaths [
31]. In Tanzania where abortion is highly restrictive, no national data are available, and the incidence of unsafe abortion is hard to estimate since it is presumably hidden behind a high number of miscarriages. However, a study from 2013 [
32] found that the majority of the abortions carried out were clandestine and a major contributor to maternal death and injury.
Globally, countries have been categorised by their abortion laws in diverse ways, commonly along a continuum from ‘severely restrictive’ to ‘liberal’ [
33] or ‘prohibited altogether’ to ‘no restrictions as to reason’ [
34]. At the restrictive end of the continuum are countries that prohibit abortion entirely or permit it only to save the life of the mother. Tanzania with its restrictive law permitting abortions only to save the life of the pregnant woman, sorts under this category. The law however includes explicit provision in the penal code exempting providers from punishment if they perform an abortion to save a woman’s life [
35]. In the middle of the continuum lies Ethiopia which permits abortion to secure maternal life and health, and on grounds related to age and capacity to care for a child [
36,
37]. Zambia is categorised in the liberal end of the continuum allowing abortion on both health-related and socio-economic grounds [
38]. Countries classified in the very liberal end of the continuum having laws that permit abortion with few restriction, are not represented in our material (see [
33]). The table (Table
1) below sums up the content of the three countries’ abortion laws, and key reproductive health indicators.
Table 1
Restrictiveness of abortion laws and reproductive health indicators
Restrictiveness of the abortion law* | Abortion allowed to preserve physical or mental health and socio-economic reasons | Abortion allowed to secure maternal health and on grounds related to age and capacity to take care of a child | Abortion severely restricted and only legal to save the life of the mother |
Maternal mortality ratio | 224 | 353 | 398 |
Fertility rate** | 4.9 | 4.1 | 5.0 |
Contraceptive prevalence girls 15–19*** | 28.1 | 8.9 | 14.9 |
Contraceptive prevalence 15–49*** | 40.8 | 28.3 | 34.4 |
Unmet need for family planning*** | 26.6 | 26.3 | 25.3 |
As we shall discuss in this paper the categorization of countries along a liberal-restrictive continuum based on their abortion law tells us very little about the reality of access to safe abortion services.
Methods
Our research was based on qualitative exploratory research and had a cross-country comparative design. It involved studying 1) the historically and contextually embedded content of abortion law and policy, and 2) abortion-related policy processes through the exploration of ideas, positions and practical engagement in abortion-related work by actors within the field.
A review of central law and policy documents from the three countries was carried out in 2016–18. In addition, qualitative interviews were carried out with actors differently positioned within the field of abortion. This approach is well aligned with the classical call for ‘studying up’ in anthropology [
39,
40], i.e. studying the views of powerful actors located in bureaucratic positions, in our case actors within ministries, NGOs and religious organizations. Six out of seven co-authors (AB, KMM, HH, GT, RS, MH) took part in at least one of four interview rounds with key stakeholders in Ethiopia, Tanzania and Zambia in 2016 and 2017. The article also draws upon abortion-related material generated in SAFEZT sub-studies by two of the co-authors (RS and MH).
Through discussions in the research team key policy institutions, organisations and actors within the field of abortion were identified within each of the three study contexts. Recognizing the important part played by actors beyond the government structure in policy making and implementation, we recruited actors from a broad spectrum of organizations and institutions. These included ministries, non-governmental organizations, UN agencies, professional associations and religious organizations representing diverse positions in the abortion debates. The list was expanded during the course of the research. By and large parallel organizations were recruited in the three countries (cf table
2 below). However, as it was deemed vital to represent different positions and prominent voices in the abortion debates in the individual countries, there is also a certain variation. We interviewed a total of of 79 individuals within the following categories: ministries (MIN), religious organisations (RO), non-governmental organisations (NGO), international non-governmental organisations (INGO), UN agencies (UN), professional organisations (PO), health workers (HW), journalists (J) and others (O). See table below (Table
2). In the manuscript we refer to the various actors using these abbreviation with Z for Zambia, E for Ethiopia and T for Tanzania.
Table 2
Overview of categories of actors included in the study
Ministries (MIN) | 4 | 3 | 4 |
Religious organisations (RO) | 7 | 5 | 6 |
Non governmental organisations (NGO) | 5 | 5 | 2 |
International non-governmental organisations (INGO) | 4 | 8 | 5 |
UN agencies (UN) | 0 | 3 | 1 |
Professional organisations (PO) | 4 | 2 | 0 |
Health workers (HW) | 0 | 0 | 6 |
Journalists (J) | 2 | 0 | 0 |
Other (O) | 2 | 1 | 0 |
TOTAL | 28 | 27 | 24 |
A formal invitation letter was sent to the selected institutions/organisations. Nearly all individuals or organizations that were contacted agreed to take part in an interview, and some were re-interviewed after a year. The study participants were informed about the project in writing by email prior to the fieldwork and at the onset of the interview. Information was also provided about key research ethical principles. Written or oral informed consent was secured from all study participants. The study received ethical clearance from Regional Ethical Committee Western Norway, Norway (2017/1191) and data management clearance from Norwegian Centre for Research Data (57089/3/00SIRH); ethical clearance from the University of Zambia Biomedical Research Ethics Committee (009-07-17) and National Health Research Authority in Zambia (MH/101/23/10/1 and research clearance and registration from the University of Dar es Salaam (CoSS- SO18011). In Ethiopia the research was carried out following social science research procedures at Addis Ababa University.
The interviews were carried out in English and were guided by semi-structured and flexibly monitored interview guides. The informants were, by and large, articulate and actively engaged in the discussions. The topics raised included abortion policy, the role and activity of their organisation within the field of abortion, perceptions on their country’s abortion law and policy as well as on girls’ and women’s access to safe abortion services in their country. Most reflected critically on the topics raised.
The interview material was audio recorded, transcribed and analyzed throughout the data collection phase and during shorter intervals following each phase, with a comparative analysis taking place at the end of the data collection. During the comparative phase a full review of the material took place to gain an overview and to identify major patterns, including cross-cutting, contrasting or contradictory themes emerging in the material. The review was followed by the manual coding of the entire data set. Central content was subsequently moved into a separate document under headings which reflected the various dimensions of the main emerging themes. This document formed the basis for further analysis and write up of the material.
The team consisted of Ethiopian, Tanzanian, Zambian and Norwegian researchers, all employed at departments of social science or public health at national universities. All co-authors have substantial experience from long-term ethnographic research, primarily from research with a ‘reproductive health’ focus from eastern and southern Africa.
Discussion
Abortion laws and access to abortion services
This study has aimed to shed light on the complex web of factors that mitigate the relationship between law, policy and practice, questioning assumptions about the law in order to understand actual access to services.
In line with Walt and Gilson’s [
14] call to move beyond a narrow focus on the
content of policy, our study demonstrates that a broad classification of abortion laws along the liberal -restrictive continuum (see e.g. [
33]) has limited value in terms of understanding women’s access to safe abortion services. This study’s findings reveal that the law texts that make up the three national abortion laws are highly ambiguous. The Zambian abortion law at the liberal end of the continuum, permitting safe abortion on broad social and medical grounds, is profoundly affected by the requirement for three consenting signatures by medical doctors, which is hardly possible to obtain even in hospitals in urban areas. By contrast, in Ethiopia, the abortion law is placed under the Penal Code signalling that abortion is illegal, while at the same time the law and policy guidelines state that a woman’s word that she was raped, a victim of incest or is underage is enough for her to qualify for legal abortion. In theory, these clauses make abortion widely accessible although, as we have seen above, the reality is more complex. Finally, in Tanzania, the highly restrictive status of the abortion law is mitigated by what seems to be a lenient attitude to both provider-induced and self-induced medication abortion and limited prosecution of illegal abortion-seekers and providers. Interestingly, the text of the law ‘to save the life of the mother’ and the demand for only one health worker to decide on whether the abortion-seeking woman is eligible for legal abortion services, leaves a lot of discretionary power with the individual health workers.
Hence, in our three country cases, the relationships between law texts and actual access to services appear to be rather paradoxical. In order to enhance the understanding of such apparent ambiguities and paradoxes, we will, in line with Walt and Gilson [
14], turn our attention to the
contexts within which central abortion-related
actors and
processes are operating.
Locating abortion laws and actors in context
Throughout our study, we met actors, differently positioned, with different interests in abortion as a religious, public health or rights issue, and with different powers to make their position relevant to the public and to policy process.
Despite the conservative, anti-abortion environment in Ethiopia where the Ethiopian Orthodox Christian Church continues to enjoy cultural power and to a large extent shape public opinion in moral matters [
43] the restrictive abortion law was replaced by a law that drastically expanded the grounds on which women could access legal abortion. The revision took place in an alliance between a number of
civil society actors and
key actors in the Federal Ministry of Health, promoting safe abortion as a public health measure to reduce maternal mortality. To understand how this radical move could happen, we need briefly to remind the reader of the Ethiopian political
context which has been characterized by powerful and authoritarian regimes with substantial power to fight through their agenda. At the turn of the century, the regime put the Millenium Development Goal (MDG) on maternal health (MDG 5) high on the political agenda. Avoiding a tenuous framing of induced abortion as a women’s rights issue, the governmental discourse gained legitimacy through the aim of protecting girls and women from the adverse health implications of unsafe abortions, and ultimately of reducing abortion-related death rates [
6]. In the contentious climate of the revision of the law, the abortion law was retained within the penal code, signalling to the public that abortion is illegal in Ethiopia, while the Ministry of Health was mandated to make safe abortion services accessible. Operating within this tension between the religious communities’ concern about the sanctity of life and public health aims, the government installed the most permissive abortion law in Eastern Africa. In the past decade, the Government of Ethiopia has demonstrated its capacity to implement the abortion policy and increase accces to safe abortion services on the basis of its public health ideology despite low popular support. The approach, as we have indicated in this paper, has been low profile and ‘silent’ in order not to create resistance. The scaling up of services and the implementation of safe abortion care has therefore probably been slower than a fully open approach would permit, but with an open approach the risk of backlash would have been higher.
In Zambia, the public stand has been intimately connected to the religious-moral dimensions of abortion, representing induced abortion as a moral and legal offence. As seen above, Zambia declared itself a Christian nation in 1991, and religious language has become the language of politics in the country. Indeed a conservative Christian discourse has, through Zambia’s recent history, become increasingly powerful and has emerged among others in a subtle anti-abortion discourse. The recently proposed Bill of Rights that included a clause stating that the right to life begins at conception, potentially with vast implications for abortion-seeking women, revealed the political strength of the anti-abortion actors. This process brought the abortion issue, that had been silenced, back onto the political agenda and constrained the political scope of action for actors working to liberalise the law.The constitution review process was seen by some civil society actors as a tactic to conceal the abortion issue among the series of progressive rights proposed in the bill. This process highlights the restrictive nature of the abortion environment in Zambia with consequences for women’s access to comprehensive reproductive care [
44].
In Tanzania where Islam and Christianity are practised by the vast majority of the population, the presentation of abortion as a sin and as a moral transgression predominates public discourse. Although Tanzania ratified the African Charter’s Protocol on the Rights of Women in Africa [
45] (also referred to as the Maputo Protocol), which requires the government to “protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, [and] incest, and where the continued pregnancy endangers the mental and physical health of the [pregnant woman] or the life of the [pregnant woman] or the foetus.”(p. 16), it never domesticated it. Nevertheless, in the context of high maternal mortality rates and with the aim of achieving MDG 5 on maternal health, the government and allied actors within the large international NGO sector have taken important steps to reduce maternal mortality including deaths caused by unsafe abortion. This is spelt out in the National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania, 2008–2015 [
46]. Furthermore the Tanzanian Food and Drugs Authority (TFDA) approved the use of misoprostol for the treatment of incomplete abortion in 2011 [
32] which spurred a demand for Misoprostol off label. The Government has not acted upon this development despite the fact that it has been debated in the media. Hence, the context of implementation of the abortion law is multifaceted and implementation of the law seems to be an expression of this. (The three country cases are elaborated in separate case studies in this thematic issue/series.)
The messiness of abortion policy and the paradox of access
As demonstrated at the start of this paper, Wedel et al. [
16], and Shore et al. [
18] have criticized the manner in which policy studies have often presented policy as orderly, leaving out the messiness, the unpredictability and the disorderly elements of policy processes. Our material speaks to the disordered and rather confusing articulation between law, policy and practice, a messy scenario with implications for access. In the case of abortion policy and practice, key dynamics behind the messiness has to do with the fundamental dilemma of recognizing that induced abortions are carried out whatever the law says, hence allowing for the existence of arenas where abortions can take place invisibly and relatively safely, and without having to take up a morally impossible position of publicly fighting for rights to legal abortion.
With a legal framework that allows abortion on broad grounds, and a political environment dominated by anti-abortion discourse, Zambia is a good example of the messiness of policy processes. Informants explained how the law text itself provides important barriers to access through the request for the three signatures. But these barriers can sometimes be partly mitigated for example by the presence of Chinese clinics operating outside the legal framework or the recent increase in access to Misoprostol and combination packs for medical abortion over the counter for abortion-seeking women and girls in urban centres.
Within the highly restrictive legal abortion context in Tanzania, we found a complex discursive abortion landscape and a lack of systematic or large scale prosecution of abortion seekers and providers. This seemed to leave substantial room for health worker discretion, and allowed abortion services to be provided clandestinely by both trained and untrained individuals. Public post-abortion care services were available to prevent complications. The burgeoning illegal market for Misoprostol sold off label moreover opened access to medical abortion for urban women.
In the far more permissive legal context in Ethiopia, linked to the power vested in the claims of the woman, clinical guidelines have been developed to guide safe abortion procedures, health workers increasingly receive training, and services are gradually rolled out to the population. However, rather than encountering a context of ready access to safe abortion services for those who fulfill the criteria in the law, our material indicates that a number of factors continue to seriously limit access. The government’s fear of informing the public about the law so as not to appear as a state promoting induced abortion which could cause uproar at grassroots level, has caused information to be held back, limiting both knowledge about the law and the full roll-out of services. Even when public services are available, women may refrain from using them for the fear of disclosure in the community, while health workers act as gate keepers and may dismiss women because of religious conscience. The increasing availability of safe abortion services thus to some extent remains silenced, the law is not widely known, and high numbers of young women continue to resort to unsafe abortion procedures [
47,
48]. Despite the slow progress, a relatively liberal law is long since in place, there is a careful but steady roll out of abortion services, and there is an acceptance for the increasing availability of Misoprostol and emergency contraception. These factors all speak to the continuous but silent attempts to expand the services in a context of massive anti-abortion sentiments.
What we encountered was a relationship between abortion-related policy- and access scenarios that emerged as paradoxical, where an inherent aspect of the ambiguity and messiness opened up for a substantial degree of political pragmatism. We found that even the most conservative and restrictive contexts to some extent, ultimately allowed avenues of access to abortion services to exist or operate. We encountered governments that quietly accepted that clandestine abortion services operated; governments that did not systematically prosecute illegal abortion seekers, abortion providers or vendors of illegal abortion drugs, and religious leaders who refrained from fights against the liberalization of the law. These paradoxical scenarios all suggest a pragmatic approach to implanting and enforcing abortion policies. The dynamics at work indicate that policy makers, religious leaders and other key actors in the field pragmatically manoeuvre between ways of relating to a highly stigmatized public health challenge that causes suffering and death among vast numbers of girls and women in their communities and their own desire to remain morally clean. The articulation between the strong public condemnation of abortion encountered at all levels in the three countries and the pragmatic stance towards loop holes in the system most powerfully surfaces through the rapidly increasing availability and accessibility of medical abortion drugs [
49].
In this comparative research project in Tanzania, Zambia and Ethiopia, we encountered a seemingly paradoxical relationship between national abortion laws, abortion policy and women’s actual access to abortion services. We do not question the close relationship between restrictive abortion laws, illegal and unsafe abortion and high maternal mortality scenarios documented globally. We do however, based on the material in this study, wish to contribute modestly to the literature that cautions against a too narrow focus on the content of legal and policy documents in assessment of outcomes, in this case the content of abortion laws versus access to abortion services. Through an analysis of contexually embedded actors differently situated vis-à-vis abortion policy and process, we can gain a more credible picture of actual access to safe abortion services in a given context. This implies being open to the messiness of policy processes. In our material the messiness has revealed a pragmatism characterizing even the most restrictive abortion contexts, a pragmatism likely to be linked to a realization that no law can prevent abortions from taking place. The pragmatism is particularly visible through the burgeoning Misoprostol market. This market, although hampered by general challenges linked to the marketing of drugs in low income contexts, entails considerable hope and anticipation through the drug’s ability to bypass both restrictive abortion laws and health workers as gate-keepers of access to safer abortion services.
Study strengths and limitations
Studying law and policy processes calls for particular researcher reflexivity not the least because of the immense complexity of the topic. The research team recognizes the substantial limits to awareness given the particular constraints imposed by the controversial and sensitive nature of the study topic. This said, we believe that a comparative case study approach, including different country contexts, was fruitful in disentangling findings with increased transfer value. The quality of the study was, we believe, strengthened by the inclusion of informants differently postioned vis-à-vis the study topic. Finally, we think that a team of national and foreign researchers, schooled in the critical social sciences, and with substantial ethnographic research experience from the same African contexts, enhanced the quality of the research material.
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