3.2. Trends in legal, Policy and Institutional Reform

3.2.1. Legal Reforms

During the AWD, some North African countries passed legislative reforms addressing reproductive health. In 2016, Mauritania approved its Reproductive Health Law. This recognises reproductive health care as a universal human right by providing access for women to reproductive health services, such as modern contraceptive methods.1175 Algeria passed Health Law No. 18/11 in 2018, which includes a specific section on maternal and child health and provides for reproductive health and family planning services.1176 Egypt passed Law No. 23 of 2012 on health insurance for women heads of households. 1177 Concerning abortion, in 2016 Morocco amended Article 453 of the Penal Code on Abortion, under which abortion is not punishable in cases where the mother’s life is in danger, in cases of violence or incest, if the person has a mental disorder or if the foetus has a serious malformation or a genetic disease.1178

3.2.2. Policy and Institutional Reforms

Over the span of the Decade, all countries, except for Sahrawi Arab Democratic Republic (no data found), took steps to improve women’s SRHR, maternal rights and management of HIV/AIDS through policy reform. Three countries (Algeria, Mauritania and Morocco) adopted national strategies to combat HIV/AIDS during the AWD. Two countries (Mauritania in 20101179 and Tunisia in 20111180) launched CARMMA campaigns.

Regarding reproductive health, Algeria, Egypt, Mauritania and Morocco have implemented strategies to improve access to SRH services. Mauritania’s National Reproductive Health Strategy 2011–2015 prioritised safe motherhood and youth and adolescent SRH, and providing family planning services and contraceptives free of charge.1181 Egypt implemented the National Health Strategy for Reproductive Health 2015–2020;1182 the Ministry of Education incorporated components on reproductive health in the school curriculum. Algeria, Mauritania and Morocco have adopted policies and plans that specifically address maternal mortality. Algeria adopted the National Plan to Prevent Maternal Deaths 2015–2019 and Morocco the Sector Strategy 2012–2016 that improved access to treatments and enhanced maternal and child health.

Some countries in the North African region have also implemented institutional reforms that address reproductive and maternal health. Mauritania implemented the Improving Maternal and NewBorn Health and Maternity without Risk projects and established the Obstetrical Package, a voluntary insurance scheme covering maternal health costs in public health facilities at all levels. In Libya, the Ministry of Social Affairs of the Government of National Accord, together with the United Nations Support Mission, held joint programmes and training workshops and met health-related needs.1183 In 2016, a court in Egypt issued a ruling that prohibited HIV discrimination in the workplace.1184 Figure 18 North Africa: Contraceptive prevalence, any methods (% of women ages 15-49)

Mauritania 17.8%

Libya 27.7%

Algeria 57.1%

Egypt 58.5%

Tunisia 62.5%

Morocco 70.8%

No data available for Saharawi Arab Democratic Republic Source: The World Bank, World Development Indicators.