Strategic framework

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abortion remains unregistered in the country, although the medications used in this method can be purchased on the black market. There are no indications that untrained medical staffs are performing abortions because only specialist gynecologists or obstetricians are allowed by law to perform abortions and such staff, during their medical education receives adequate training and practice for proper performance of termination of pregnancy. The gynecologists and obstetricians generally agree to the incorporation of WHO standards and protocols for performing safe abortion, however many of them feel that existing methods are safe and satisfactory enough. It is noteworthy to express the lack of motivation for learning new methods and improving the knowledge and skills among this group of health professionals. The counseling before and after abortion is not always performed by gynecologists, especially in stateowned hospitals and there are no existing counseling protocols. Often such counseling is not considered as part of the service of performing an abortion. According to the Law on Health Insurance, if termination of pregnancy is not medically induced, such procedure will not be covered by the basic medical insurance scheme, thus all expenses must be covered by the patient without regard if the patient possesses medical insurance or not. There are no social or other criteria that will enable some groups of patients to enjoy discounts, or to pay participation fees or be exempt from paying medical fees for abortion. In public outpatient facilities the abortion procedure now costs between 65 and 95 US dollars, while in private clinics such fees may be as high as 170 up to 185 US dollars. The legal aspects concerning the performance of abortion are contained in the Law on Termination of Pregnancy adopted in 1972 and amended in 1976 and 1995. This law is particularly liberal in terms of its recognition of women’s rights of making a free choice with regard to their pregnancy up to the 10th gestination week of pregnancy. This law defines termination of pregnancy as special medical intervention that maybe performed on a pregnant woman who voluntarily agrees to it. According to this Law the right of choice may be limited only if there are indications that there is danger to the life of the pregnant woman in question. However during the course of 2008 a number of political religious groups forcefully staged attempts of delegitimization of sexual and reproductive rights of women, mounting a fierce campaign against the right of women to make free choice whether or not to terminate their pregnancy. With the appearance and intensification of an anti-abortion movement in Macedonia, as well as with the use of nationalist and religious rhetoric on the part of some groups, women’s rights of making free choice with regard to pregnancy termination was strongly condemned, attacking and underestimating the reproductive rights enjoyed by women to make free choices about their health, life and integrity. In short we may summarize the following events that took place:

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