La santé sexuelle et reproductive en Tunisie. Institutions médicales, lois et itinéraires thérapeutiques des femmes après la révolution

Maffi, Irène; Affes, M.

doi:10.4000/anneemaghreb.3228

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…Before examining the abortion itineraries of seven women, we would like to stress that this article is the result of a research collaboration between Malika Affes, a midwife who has been working in Tunisian public facilities for more than 20 years, and Irene Maffi, a social anthropologist based in Switzerland studying reproductive and sexual health in the Arab world 13 . Our analysis draws on participant observation, the examination of medical files, interviews with women and health care providers, and the personal experience of Affes as a practitioner involved in abortion services.…”

Section: Methodsmentioning

confidence: 99%

Family Life in Tunisia after the Revolution of 2011

Maffi¹

2017

Anthropology of the Middle East

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In this article, we explore the effects that Tunisia’s post-revolutionary democratization process has had on the right to abortion, drawing on ethnographic material, interviews, and medical files that we collected between 2013 and 2017, as well as the professional experience of one of us. We show that despite the existence of a relatively liberal abortion law for more than 40 years, women in Tunisia have trouble getting abortion care for economic and organizational but also ideological and political reasons. The existence of the abortion law constitutes but one factor among many others that determine women’s ability to access abortion services; medical practices and women’s abortion itineraries are caught up within complex arrangements that entail multiple socioeconomic and cultural factors, political transformations, the variability of rules in medical and administrative institutions, and contradictory interpretations of the legal apparatus. Examining the abortion itineraries of seven women we met in a large hospital in Tunis, we argue that these abortion itineraries shed light on the ordinary constraints experienced by poor Tunisian women who cannot afford to turn to the private sector. We maintain that attitudes toward the right to abortion in post-revolutionary Tunisia are problematic and that the democratization of local society has brought about unexpected consequences that do not extend but rather reduce women’s rights in the domain of sexual and reproductive health.

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Section: Methodsmentioning

confidence: 99%

Family Life in Tunisia after the Revolution of 2011

Maffi¹

2017

Anthropology of the Middle East

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“…They usually do not understand that abortion is their right, and that providers should offer them this service and see it more as a ‘concession’ ( Amuchastegui and Flores, 2013: 921 ) or a ‘moral debt’ to the provider ( Krauss, 2018: 694 ). After the revolution, many women were turned away in the public sector ( Hajri et al, 2015 , Maffi and Affes, 2017 ) and had trouble obtaining appropriate and timely abortion care because health providers or administrative personnel refused their requests. A considerable number of women I met had been to two or three facilities before getting abortion care, causing them anxiety, fear, loss of time and considerable costs in relation to their meagre income.…”

Section: Ignorance Of the Lawmentioning

confidence: 99%

“…Clinicians often told me that medication abortion had brought about the banalization of this act – that many women do not think they are ‘killing a baby’ if they just have to take some tablets – and that it has caused a tremendous increase in the abortion rate. All these allegations are unfounded if we consider that the number of abortions has remained stable in the public sector since the introduction of medication abortion, that most women I met did use contraception – according to the World Bank, the contraceptive prevalence in Tunisia was 62.5% in 2012 ( World Bank, 2012 ) – and that the procedure they had to go through to get an abortion was troublesome and thus not easily undertaken ( Hajri et al, 2015 , Maffi and Affes, 2017 , Maffi and Affes, 2019 ). In addition, many providers, especially after the revolution, were openly hostile to abortion for moral or religious reasons.…”

Section: Ignorance About Women’s Attitudes and Motivationsmentioning

confidence: 99%

The production of ignorance about medication abortion in Tunisia: between state policies, medical opposition, patriarchal logics and Islamic revival

Maffi¹

2022

Reproductive Biomedicine & Society Online

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In Tunisia, medication abortion has been available in government reproductive and sexual health clinics since the early 2000s. Since its introduction, it has rapidly replaced the surgical method, and between 75% and 80% of abortions in the public sector were performed using the pharmacological protocol in 2016. In this article, I intend to discuss the various forms of ignorance about medication abortion that exist in Tunisia among several categories of actors in relation to the legal, medical and religious domains. I explore how the existing ‘varieties of ignorance’ are related to the specific political, social and economic positions of the involved actors, the dominant gender regime, specific institutional policies and economic interests. I also investigate how some forms of ignorance are wilfully produced by institutions and individuals, whereas others are the result of positionality or organizational features. I first describe when and how medication abortion was introduced in Tunisia and the forms of resistance it elicited; later, I examine the production of ignorance about this technology after the revolution of 2011. I mainly consider practices and discourses of health professionals, but also those of women seeking abortion care in the public sector, and those of the activists of a Tunisian non-governmental organization operating in the domain of women’s health and rights.

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Revisiting fertility regulation and family ties in Tunisia

Frini

Müller

2023

BMC Pregnancy Childbirth

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Background We revisit fertility regulation in Tunisia by examining the role of the extended family. As marriage is the exclusive acknowledged childbearing context, we examine fertility analysis in Tunisia through the sequence: woman’s marriage age, post-marriage delay in the first use of contraception, and past and current contraceptive use. We trace the family socio-economic influences that operate through these decisions. Methods Using data from the 2001 PAP-FAM Tunisian survey, we estimate the duration and probability models of these birth control decisions. Results In Tunisia, family ties and socio-cultural environment appear to hamper fertility regulation that operates through the above decisions. This is notably the case for couples whose marriages are arranged by the extended family or who benefit from financial support from both parental families. Conclusion This calls for family planning policies that address more the extended families.

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La santé sexuelle et reproductive en Tunisie. Institutions médicales, lois et itinéraires thérapeutiques des femmes après la révolution

Cited by 3 publications

References 6 publications

Family Life in Tunisia after the Revolution of 2011

Family Life in Tunisia after the Revolution of 2011

The production of ignorance about medication abortion in Tunisia: between state policies, medical opposition, patriarchal logics and Islamic revival

Revisiting fertility regulation and family ties in Tunisia

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