Nobody asked the mother: women and maternity on Simbo, western Solomon Islands

The experience of abortion for Cook Islands women: exploring the socio-cultural dimensions of abortion safety

Abortion is significantly restricted by law in most Pacific Island countries, impacting the rights, health and autonomy of people who experience pregnancy. We undertook qualitative research between February and August 2022 on Rarotonga, Cook Islands, where abortion is illegal under most circumstances. We conducted interviews with women who had accessed or tried to access abortion services; people who had supported women to access abortion services; health workers; and advocates to understand their experiences regarding abortion. We conducted focus groups to explore broader social perceptions and experiences of sexual and reproductive health and rights, including abortion. Participants described their abortion decisions and methods, and their negotiation of the personal context of their sexual behaviours, pregnancies, and abortions relative to their socio-cultural context and values. As defined by the World Health Organization, safe abortion relates to the methods and equipment used and the skills of the abortion provider. We argue for an expansion of this definition to consider inclusion of reference to individuals' 'abortion safety nets' as the sum of their access to financial, political, health care and socio-cultural resources. These safety nets are shaped by discourses related to abortion and socio-cultural support and values, impacting physical, emotional, psychological, social and spiritual health.

Assessing women's understandings of health in rural Papua New Guinea: implications for health policy and practice

In Papua New Guinea (PNG), women's health is addressed by applying biomedical solutions which often ignore the complexity of women's histories, cultural contexts and lived experiences. The objective of this study was to examine adult and older women's perceptions of health and well-being to identify priority areas for public service interventions. Rapid ethnographic assessment was conducted in the Wosera district, a rural area of PNG from mid-2005 to early 2006, to examine the health concerns of women. Twenty-seven adult women and 10 older women participated in the study. Health was not limited to one aspect of a woman's life, such as their biology or maternal roles; it was also connected with the social, cultural and spiritual dimensions of women's daily existence. Participants also identified access to money and supportive interpersonal relationships as significant for good health. A disconnect was found to exist between women's understandings of good health and socio-political health policies in PNG, something likely to be repeated in health service delivery to different cultural groups across the Asia Pacific region. Health and development practitioners in PNG must become responsive to the complexity of women's social relationships and to issues relating to the context of women's empowerment in their programmes.

Family planning: personal and political perspectives from Choiseul Province, Solomon Islands

Rapid population growth has put family planning on personal and political agendas in the Solomon Islands. With the release of a population policy in 1988, national leaders sanctioned the concept of family planning as a key strategy in reducing the rate of population growth. On a personal level, Solomon Islanders share their government's concern about population problems. There is a shortage of arable land, health services are stretched, and there are limited places in school for children. A study in Choiseul Province, a rural area in Solomon Islands, suggests that people want smaller families but have limited means to control their fertility. Meagre resources and infrastructure, compounded by geography, climate, culture and religion, constrain the development of family planning services.