From Criminalization to Constitutional Rights: Analyzing Nepal’s Safe Abortion Policy Reform through the Advocacy Coalition Framework

Geha Nath Khanal, Nepal Public Health Professional Council

Unsafe abortions are major contributor to maternal mortality, with 25 million unsafe procedures occurring annually, primarily in developing countries. In response, Nepal implemented Safe Abortion Services (SAS) in 2004 after a 2002 legal reform, further securing abortion rights through the endorsement of specific Reproductive Health Act in 2018. This study examines the gradual liberalization of Nepal's abortion policy, moving from criminalizing women to recognizing abortion as a fundamental reproductive right, using Sabatier’s Advocacy Coalition Framework (ACF). The study uses thematic analysis based on Sabatier’s belief system framework to review Nepal's abortion policy. The analysis emphasizes the role of advocacy coalitions, particularly pro-choice and pro-life groups, in driving policy changes to support policy reforms. Findings indicate that policy liberalization was driven by high maternal mortality from unsafe abortions, international conventions such as CEDAW and ICPD, and progressive Supreme Court rulings. Shifts in public opinion and political reforms further legitimized SAS. The 2018 extension of abortion rights highlights the role of policy learning and advocacy coalitions. Despite limitations like reliance on secondary sources and exclusion of in-depth interviews, this policy analysis though ACF offers key insights into Nepal’s evolving abortion policy. Advocacy groups successfully advanced liberal reforms, securing abortion as constitutional right.

Keywords: Sexual and Reproductive Health and Rights, Population Policies, Qualitative data/methods/approaches

See extended abstract.