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This study examined how pregnancy prevention and management services (specifically the provision of emergency contraception pregnancy testing and counselling and termination or referral for termination of pregnancy services) feature within post-rape care (PRC) services in sub-Saharan Africa. Guidance provided by the World Health Organisation was used as a benchmark for examining these issues. The study drew on a range of sources via a desk review as well as on information provided through key informant interviews. Several key messages emerge from the study’s overall findings: 1. National PRC guidelines consistently identify pregnancy prevention as an essential element of sexual assault management and all include provisions on emergency contraception for eligible survivors. Nonetheless the study reveals a disconnect between PRC guidelines and guidelines for reproductive health/family planning with the latter less likely to address the specific needs of rape survivors although many contain general provisions on emergency contraception. 2. Pregnancy management and safe abortion for survivors do not feature prominently in national sexual violence guidelines in the region with only a few exceptions. Existing provisions for pregnancy management and abortion also tend to lack detailed guidance or country-specific information that would facilitate access to these services. Pregnancy counseling is unevenly addressed across the national protocols examined. 3. Of the eight national protocols reviewed only three treat safe abortion as an essential element of care to be provided for rape survivors with clear guidance on its provision.

Access to emergency contraception and safe abortion services for survivors of rape: A review of policies, programmes and country experiences in sub-Saharan Africa